Risk factors of surgical treatment of acute aortic dissection type A

Латт, К. К.; Vasiliyev, K. N.; Bayandin, N. L.; Stupin, Victor

doi:10.17116/hirurgia201903115

Cited by 2 publications

(3 citation statements)

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“…A potential reason for this finding could be that patients who had axillar cannulation also had more preoperative chronic illness / complications, which might have influenced their overall outcome. Other authors also found that operative details differed significantly among the patients with different cannulation sites [21,23]. Other cannulation sites were found to be safe for our patients.…”

Section: Discussionmentioning

confidence: 47%

“…Moreover, no significant link between the overall early mortality and the extent of the aortic repair has been proven in literature [20]. Contrary, it was found that perioperative complications were associated with the length of cardiopulmonary bypass, which again increased complications and mortality after surgery [10,21]. In this study, it was found for the first time that if DHCA duration was ≥33.5 minutes and cross clamp time was ≥67.5 minutes, postoperative complications were more likely.…”

Section: Discussionmentioning

confidence: 57%

“…Currently, different surgical techniques are being used for dissection treatment according to the indications, based on dissection type and patient condition. Adequate operative management remains the major concern for better outcome of acute AD type A patients [20,21]. However, patients are completely different from one another, and numerous factors can impact the choice of technique and reflect surgical outcomes [22].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2021

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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.

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Section: Discussionmentioning

confidence: 47%