scholarly journals Peri-operative risk factors for in-hospital mortality in acute type A aortic dissection

2019 ◽  
Vol 11 (9) ◽  
pp. 3887-3895
Author(s):  
Miaoyun Wen ◽  
Yongli Han ◽  
Jingkun Ye ◽  
Gengxin Cai ◽  
Wenxin Zeng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Aortic Dissection ◽  
Hospital Mortality ◽  
Type A ◽  
Operative Risk ◽  
Acute Type ◽  
Type A Aortic Dissection

scholarly journals Incidence- and In-hospital Mortality-Related Risk Factors of Acute Kidney Injury Requiring Continuous Renal Replacement Therapy in Patients Undergoing Surgery for Acute Type a Aortic Dissection

2021 ◽  
Vol 8 ◽  
Author(s):  
Xuelian Chen ◽  
Jiaojiao Zhou ◽  
Miao Fang ◽  
Jia Yang ◽  
Xin Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Replacement Therapy ◽  
Aortic Dissection ◽  
Hospital Mortality ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Type A ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Independent Risk Factors

Background: Few studies on the risk factors for postoperative continuous renal replacement therapy (CRRT) in a homogeneous population of patients with acute type A aortic dissection (AAAD). This retrospective analysis aimed to investigate the risk factors for CRRT and in-hospital mortality in the patients undergoing AAAD surgery and to discuss the perioperative comorbidities and short-term outcomes.Methods: The study collected electronic medical records and laboratory data from 432 patients undergoing surgery for AAAD between March 2009 and June 2021. All the patients were divided into CRRT and non-CRRT groups; those in the CRRT group were divided into the survivor and non-survivor groups. The univariable and multivariable analyses were used to identify the independent risk factors for CRRT and in-hospital mortality.Results: The proportion of requiring CRRT and in-hospital mortality in the patients with CRRT was 14.6 and 46.0%, respectively. Baseline serum creatinine (SCr) [odds ratio (OR), 1.006], cystatin C (OR, 1.438), lung infection (OR, 2.292), second thoracotomy (OR, 5.185), diabetes mellitus (OR, 6.868), AKI stage 2–3 (OR, 22.901) were the independent risk factors for receiving CRRT. In-hospital mortality in the CRRT group (46%) was 4.6 times higher than in the non-CRRT group (10%). In the non-survivor (n = 29) and survivor (n = 34) groups, New York Heart Association (NYHA) class III-IV (OR, 10.272, P = 0.019), lactic acidosis (OR, 10.224, P = 0.019) were the independent risk factors for in-hospital mortality in patients receiving CRRT.Conclusion: There was a high rate of CRRT requirement and high in-hospital mortality after AAAD surgery. The risk factors for CRRT and in-hospital mortality in the patients undergoing AAAD surgery were determined to help identify the high-risk patients and make appropriate clinical decisions. Further randomized controlled studies are urgently needed to establish the risk factors for CRRT and in-hospital mortality.

scholarly journals Risk factors for hypoxemia following surgical repair of acute type A aortic dissection

2016 ◽  
pp. ivw272
Author(s):  
Nan Liu ◽  
Wei Zhang ◽  
Weiguo Ma ◽  
Wei Shang ◽  
Jun Zheng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Aortic Dissection ◽  
Surgical Repair ◽  
Type A ◽  
Acute Type ◽  
Type A Aortic Dissection

scholarly journals Preoperative hematological parameters are inadequate for predicting mortality in Stanford Type A aortic dissection repair

2021 ◽  
Vol 5 (2) ◽  
pp. 01-06
Author(s):  
Selim Durmaz ◽  
◽  
Ömer Faruk Rahman ◽  
Keyword(s):  
Risk Factors ◽  
Aortic Dissection ◽  
Roc Analysis ◽  
Circulatory Arrest ◽  
Hematological Parameters ◽  
Demographic Data ◽  
Type A ◽  
Hospital Death ◽  
Acute Type ◽  
Type A Aortic Dissection

Background: Mortality in acute Type A aortic dissection is still high and unpredictable. We aimed to investigate the validity of preoperative hematological markers and possible risk factors in predicting in-hospital mortality in patients operated with deep hypothermic circulatory arrest method. Methods: 78 consecutive patients who were admitted to the emergency service and operated on were retrospectively analyzed. Risk factors for in-hospital death were investigated to develop a predictive model. Results: There was no difference between patients in terms of the were demographic data of the patients. In the mortality group, only preoperative creatinine levels were found to be higher (p < 0.05). Factors affecting mortality were found as total circulatory arrest (TCA) and cross-clamp (X-clamp) times when intraoperative data were examined (p < 0.05). ROC analysis was performed to determine the power to predict mortality and to determine the cut-off point. In ROC analysis to predict mortality, X-Clamp time > 71 minutes, 68.2% sensitivity and 66.1% specificity, TCA > 44.5 minutes, 72.7% sensitivity and 73.2% specificity were found. In the mortality group, these values were found to be significantly higher than those who were discharged. Conclusion: In the surgical treatment of Type A aortic dissection under deep hypothermia, hematologic biomarkers may be insufficient in estimating the risk for mortality. Keywords: Acute; aortic dissection; biomarker; mortality

Influence of Luminal Communication on Aortic Enlargement after Hemiarch Replacement for Acute Type A Aortic Dissection

2019 ◽  
Vol 68 (04) ◽  
pp. 294-300
Author(s):  
Gaku Uchino ◽  
Takeshi Yoshida ◽  
Bunpachi Kakii ◽  
Masato Furui
Keyword(s):  
Risk Factors ◽  
Growth Rate ◽  
Aortic Dissection ◽  
Univariate Analysis ◽  
Type A ◽  
Aortic Diameter ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Independent Risk Factors ◽  
Hemiarch Replacement

Background Aortic enlargement after hemiarch replacement (HAR) for acute type A aortic dissection (AAAD) is a serious problem. We reviewed our experience and analyzed the risk factors for aortic enlargement. Methods During April 2005 to December 2017, 364 patients underwent HAR for AAAD. Seventy-three patients fulfilled the inclusion criteria. We analyzed the change in aortic diameter, aortic growth rate, and major adverse aortic events (MAAEs) and their association with luminal communication of the aortic arch. Results Anastomotic communication, supra-aortic communication (SAC), and distal aortic communication were found in 34 (46.6%), 28 (38.4%), and 20 (27.4%) patients, respectively. The aortic growth rate was high because of the presence of SAC, distal aortic communication, and the number of coexisting aortic communication. Univariate analysis showed that the presence of SAC and an initial aortic diameter > 35 mm at 20 mm distal to the left subclavian artery and at the pulmonary artery bifurcation (PAB) were risk factors for MAAEs. Multivariate analysis showed that SAC and an initial aortic diameter > 35 mm at the PAB were independent risk factors for MAAEs. Conclusion SAC, distal aortic communication, and the number of coexisting aortic communication are significant risk factors for aortic enlargement after HAR for AAAD. SAC and an initial aortic diameter > 35 mm at the PAB are independent risk factors for MAAEs after this procedure.

scholarly journals Acute type A aortic dissection in non-agenarians: to cut or not

2020 ◽  
Vol 31 (1) ◽  
pp. 102-107
Author(s):  
Shigeru Hattori ◽  
Kenichiro Noguchi ◽  
Yusuke Gunji ◽  
Motoki Nagatsuka ◽  
Ikuo Katayama
Keyword(s):  
Aortic Dissection ◽  
Hospital Mortality ◽  
Comprehensive Evaluation ◽  
Case Reports ◽  
Type A ◽  
Rank Test ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Conservative Group ◽  
Surgical Group

Abstract OBJECTIVES Surgery for acute type A aortic dissection (type AAD) in non-agenarians is usually contraindicated due to advanced age. The aim of this study was to assess and compare outcomes after surgical or conservative treatment for acute type AAD in non-agenarians by evaluating frailty. METHODS Between October 2012 and September 2018, 273 patients underwent open repair for type AAD at the Shonan Kamakura General Hospital and the Shonan Fujisawa Tokushukai Hospital, and here, we retrospectively reviewed the case reports of 10 surgically treated non-agenarians and 15 conservatively treated non-agenarians. Exclusion criteria for surgery were the patient’s refusal of surgery, severe dementia and coma. In patients considered to be at a high risk, our judgements were based on the results of comprehensive evaluation. RESULTS Both in-hospital mortality and 30-day mortality in the surgical group were zero, while in-hospital mortality in conservatively treated non-agenarians was 73.3%. Importantly, 1-year survival in the surgical group and conservative group was 90% and 25%, respectively. The 5-year survival in the surgical group and conservative group was 49.2% and 25%, respectively (log-rank test, P = 0.0105). Four of 6 patients with preoperative clinical frailty scores not higher than 4 were still alive at 1 year with the same level of preoperative frailty. CONCLUSIONS Surgery for acute type AAD in non-agenarians can be performed with acceptable outcomes in carefully selected patients, particularly in those with preoperative clinical frailty scores not higher than 4.

Neutrophil–lymphocyte ratio may predict in-hospital mortality in patients with acute type A aortic dissection

Herz ◽  
2014 ◽  
Vol 40 (4) ◽  
pp. 716-721 ◽  
Author(s):  
S. Karakoyun ◽  
M.O. Gürsoy ◽  
T. Akgün ◽  
L. Öcal ◽  
M. Kalçık ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Hospital Mortality ◽  
Type A ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio
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