Perioperative Results and Risk Factors for In-Hospital Mortality In Patients With Stanford Type A Aortic Dissection Undergoing Sun’s Procedure - A Single Center Study

Abstract

Background: The study was to analyze the therapeutic effect and risk factors of in-hospital mortality in patients with acute Stanford type A aortic dissection operated by Sun’s procedure.
 Methods: From Jan. 2010 to March 2016, 72 patients whose data was fully accessible underwent Sun’s procedure in our hospital due to acute Stanford type A aortic dissection. Patients were divided into the survival group and the death group, and the risk factors for in-hospital mortality were collected and analyzed.
 Results: All 72 patients were diagnosed as acute Stanford type A aortic dissection by CT angiography in which the ascending aorta, aortic arch and descending aorta were involved; these patients were operated by Sun’s procedure. The operation of proximal aorta included 39 Bentall procedure, one David surgery, and 32 ascending aorta replacement. The in-hospital mortality rate was 19.4% (14 patients). Studies showed the risk factors for the in-hospital mortality included the body mass index, cardiopulmonary bypass time, operation time, intraoperative transfusion of red blood cells and plasma volume, and the total perioperative transfusion of red blood cells, plasma and cryoprecipitate volume. Independent risk factors included the body mass index and cardiopulmonary bypass time.
 Conclusion: Acute Stanford type A aortic dissection is a severe, complex disease with high in-hospital mortality, though the Sun’s procedure is an effective surgical approach in treating this kind of disease in some center. Body mass index and cardiopulmonary bypass time are independent risk factors for in-hospital mortality.

Stanford Tip A Aort Diseksiyon Cerrahisinde Ortalama Trombosit Hacmi, Trombosit Lenfosit Oranı ve Nötrofil Lenfosit Oranının Mortalite Üzerine Etkisi

“…Aort diseksiyonu hastalarında mortalite ile ilişkisi açısından perioperatif dönemdeki birçok etken araştırılmıştır. Operasyon süresi, kardiyopulmoner by-pass süresi, perioperatif kan ve kan ürünlerinin kullanımı mortalite ile ilişkilendirilmiştir (8). Bizim çalışmamızda da kardiyopulmoner by-pass süresi Grup II'de anlamlı olarak daha yüksek bulundu.…”

“…Bizim çalışmamızda da kardiyopulmoner by-pass süresi Grup II'de anlamlı olarak daha yüksek bulundu. Preoperatif dönemde mortaliteyi etkileyen değerlere bakıldığında yüksek vücut kitle indeksinin mortalite ile ilişkili olduğu ortaya konmuştur (8,9). Yaptığımız çalışmada ise gruplar arasında istatistiksel olarak anlamlı farklılık gözlemlenmedi.…”

Risk Factors for Postoperative Mortality in Patients with Acute Stanford Type A Aortic Dissection

“…A BMI ≥25 kg/m 2 was an independent risk factor for death, which was consistent with the results of a recent study. 9 Mechanical ventilation under sedation and analgesia was generally required for patients after AD surgery. For all patients included in the present study, mechanical ventilation was performed after surgery.…”

“…A BMI ≥25 kg/m 2 was an independent risk factor for death, which was consistent with the results of a recent study. 9 Mechanical ventilation under sedation and…”

Preservation of Autologous Brachiocephalic Vessels with Assistance of Three-Dimensional Printing Based on Convolutional Neural Networks

“…The autologous brachiocephalic vessel preserved Sun's procedure is one of the sim-plified procedures of conventional Sun's procedure, and it has excellent shot-term outcomes [6,7]. Considering the requirement of comprehensive understanding of the details of patients' aortic arch (including the autologous brachiocephalic vessels) for applying the simplified procedure and the complex morphology of the aortic arch itself, the information obtained from conventional imaging examination before surgeries are relatively limited [8].…”