Li, Jing and Zerdzitzki, Matthaeus and Camboni, Daniele and Floerchinger, Bernhard and Unterbuchner, Christoph and Schmid, Christof and Rupprecht, Leopold (2021) A decade of surgical therapy in an all-comer cohort with type A aortic dissection. JOURNAL OF CARDIOVASCULAR SURGERY, 62 (4). pp. 377-384. ISSN 0021-9509, 1827-191X
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BACKGROUND: We reported on a decade of aortic surgery for type A aortic dissection to assess surgical techniques employed and outcomes over time in an all-corner analysis of a mid-size university cardiosurgical center. METHODS: From 2009 to 2018, 283 patients (189 males and 94 females, mean age 62 years, range 30-85 years), who underwent surgical therapy for type A aortic dissection in our institution were included in a retrospective statistical analysis. RESULTS: Among all the patients, 55.5% of them were hemodynamically stable, 10.3% came in intubated. A neurological deficit was present in 18.9% of cases, extremity malperfusion was noted in 17.4%, and abdominal malperfusion detected in 8.2%. The extent of the aortic dissection corresponded to DeBakey type I in 88% of cases, a thoracoabdominal involvement was seen in 64%. In 51.9% of patients, only the ascending aorta replaced, another 40.6% of patients had proximal arch replacement too. A separate stent placement into the descending aorta was achieved in 13.4% of patients, during surgery (5.7%) or thereafter (7.7%). Overall survival to discharge was 79.5%. Most frequent complications were stroke and paralysis (15.2%). but only visceral malperfusion (OR 9.0) and heart failure mandating ECMO therapy (OR 29.5) were associated with significantly increased mortality. CONCLUSIONS: Surgery for type A aortic dissection is still challenging. Along with the refinement of surgical techniques, the indication for the various procedures has moved from a simplified general strategy to a more individualized concept.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | ANTEGRADE CEREBRAL PERFUSION; ELEPHANT TRUNK TECHNIQUE; SINGLE-CENTER EXPERIENCE; REPAIR; REPLACEMENT; GRAFT; HYPOTHERMIA; GLUE; Aneurysm; dissecting; Stents; Surgical procedures; operative |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Anästhesiologie Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 02 Aug 2022 13:44 |
| Last Modified: | 02 Aug 2022 13:44 |
| URI: | https://pred.uni-regensburg.de/id/eprint/46076 |
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