Major Clinical Outcomes in Adults Undergoing Thoracic Aortic Surgery Requiring Deep Hypothermic Circulatory Arrest: Quantification of Organ-Based Perioperative Outcome and Detection of Opportunities for Perioperative Intervention

Acute kidney injury during aortic arch surgery under deep hypothermic circulatory arrest

“…The previous discrepancies in the incidence of AKI may have been caused by differences in its definition. Indeed, the incidence of postoperative RRT in our study (3.0%) was similar to those in previous reports, although the incidence of AKI was higher [3,[6][7][8][9]. Another possible explanation was false-positive labeling as AKI with the less rigorous criteria of the proposed AKI criteria brought these discrepancies [4].…”

“…Another possible mechanism of AKI is the atheroembolic burden during cardiac surgery [13]. However, the incidence and outcome of AKI during AAS in previous investigations have not been consistent (Table 6), probably because of the lack of a standardized definition and classification for AKI [3,[6][7][8][9]. This lack of standardization has likely hindered the improvement of perioperative patient management as well as the surgical outcome of AAS.…”

“…Improving the adverse outcomes associated with deep hypothermic circulatory arrest (DHCA), however, has been challenging [3,[6][7][8][9]. Although AKI is a common postoperative complication (8.3-48.2%) encountered in patients undergoing AAS under DHCA [3,[6][7][8][9], the incidence and risk factors of AKI (as defined by AKIN) during AAS under DHCA need further study.…”

Observational study of mortality risk stratification by ischemic presentation in patients with acute type A aortic dissection: the Penn classification

“…[12][13][14][15][16] The findings of this study demonstrate that ischemic presentation can be used to stratify operative mortality risk in patients with acute type A aortic dissection. Traditionally, acute type A aortic dissection was assessed according to anatomical criteria according to the DeBakey or Stanford classifications.…”

“…12,13 Briefly, all patients underwent transesophageal echocardiography under general endotracheal anesthesia to confirm the surgical diagnosis, detect concomitant cardiac abnormalities, and assess the surgical intervention. This intraoperative echocardiographic examination was undertaken in all patients, regardless of preoperative aortic imaging.…”