In-hospital mortality predictors after surgery for Stanford type A aortic dissection - single-center five-year experience

Zdravkovic, Ranko; Redžek, Aleksandar; Šušak, Stamenko; Tatic, Milanka; Videnović, Nebojša; Majdevac, Slavica; Vujic, Vanja; Vuckovic-Karan, Jelena; Miljković, Tatjana; Velicki, Lazar

doi:10.2298/sarh191115048z

Cited by 3 publications

(1 citation statement)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Currently, cannulation to establish cardiopulmonary bypass in patients with acute AD type A can be safely and efficiently performed through the femoral, subclavian, axillary artery, the ascending aorta, as well as through the left ventricular apex and the aortic valve [25,26,27]. Our results showed that axillar cannulation was associated with more frequent lethal outcome.…”

Section: Discussionmentioning

confidence: 67%

Factors influencing early surgical outcomes of patients with acute aortic dissection type A

et al. 2021

View full text Add to dashboard Cite

Introduction/Objective. Even with the current treatment mortality from aortic dissection remains high. The study aimed to evaluate the early postoperative outcome of patients with aortic dissection and identify which factors could have influence on it. Methods. The study included all consecutive patients who underwent surgery for acute aortic dissection type A from 2012 to 2017. We registered all parameters that could potentially impact the outcome (general data, medical history, clinical and cardiological diagnostic test findings, preoperative complications, type of cannulation and the operation performed, additional surgical procedures, operation duration, etc.). Patients were surgically treated according to the current protocols. The main outcome measures were complications and mortality during a one-month postoperative period. All data collected pre-, intra-, and postoperatively were compared and statistically analyzed. Results. The study included 246 patients, of an average 57.54+/-12.88 years of age and mostly male sex (74%). Early postoperative mortality occurred in 17% of patients. Preoperative chronic kidney insufficiency (p = 0.005) and cerebrovascular insult (p = 0.047) and tamponade (p = 0.036) were the major risk factors for postoperative complications and mortality. Long hypothermic cardiac arrest (p = 0.001), cross clamp (p = 0.017) and cardiopulmonary bypass time (p = 0.036) increased postoperative complications. Postoperative complications started occurring after ?33.5 minutes hypothermic cardiac arrest and ?67.5 minutes cross clamp time. Having more postoperative complications (p = 0.034) increased, while performing anterograde cerebral perfusion decreased the frequency of lethal outcome (p = 0.001). Conclusion. The majority of patients surgically treated for acute aortic dissection had good postoperative outcome. However, numerous pre-, intra- and postoperative factors can impact patient survival.

show abstract

Section: Discussionmentioning

confidence: 67%

Factors influencing early surgical outcomes of patients with acute aortic dissection type A

et al. 2021

View full text Add to dashboard Cite

show abstract

Risk factors for early death after surgery in patients with acute Stanford type A aortic dissection: A systematic review and meta-analysis

Zhang

Yang

Guo

et al. 2023

International Journal of Cardiology

View full text Add to dashboard Cite

Effects of mechanical ventilation during cardiopulmonary bypass on postoperative pulmonary complications

Zdravkovic,

Tatic,

Golubovic

et al. 2023

Med pregl

View full text Add to dashboard Cite

Introduction. It is common practice in on-pump cardiac surgery to stop mechanical ventilation when extracorporeal circulation is started or to continue with low tidal volumes. The aim of this study was to investigate whether patients ventilated with low tidal volumes had a lower percentage of postoperative pulmonary complications compared to patients who were not ventilated during cardiopulmonary bypass. Material and Methods. This retrospective study included patients who underwent coronary artery bypass graft surgery over a period of 14 months. Patients with lung diseases and those with an ejection fraction < 30% were excluded from the study. Results. A total of 499 patients were included in the study. Of these, 398 were ventilated with low tidal volumes, while 101 patients were not ventilated during extracorporeal circulation. The groups did not differ in baseline characteristics, comorbidities, and intraoperative data. Pulmonary complications were equally prevalent in both groups (ventilated 16%, not ventilated 17.8%). The most frequent were the need for prolonged mechanical ventilation (ventilated 5.8%, not ventilated 5.9%), and pleural effusions (ventilated 4.8%, not ventilated 5.9%). The incidence of pneumonia was identical in both groups (2%). Other complications were less frequent. Duration of mechanical ventilation after surgery, stay in the intensive care unit, and in-hospital mortality did not differ significantly between the groups. Conclusion. Pulmonary complications after cardiac surgery are still common. The experience at our clinic showed that the choice of mechanical ventilation strategy during cardiopulmonary bypass does not affect postoperative pulmonary complications.

show abstract

In-hospital mortality predictors after surgery for Stanford type A aortic dissection - single-center five-year experience

Cited by 3 publications

References 0 publications

Factors influencing early surgical outcomes of patients with acute aortic dissection type A

Factors influencing early surgical outcomes of patients with acute aortic dissection type A

Risk factors for early death after surgery in patients with acute Stanford type A aortic dissection: A systematic review and meta-analysis

Effects of mechanical ventilation during cardiopulmonary bypass on postoperative pulmonary complications

Contact Info

Product

Resources

About