BACKGROUND: Stanford type A acute aortic dissection is a fatal condition requiring emergency surgery. This study was designed to evaluate risk factors for hospital mortality in patients with Stanford type A acute aortic dissection. METHODS: We studied consecutive 301 patients (163 men and 138 women; mean age, 63.3 years) who underwent emergency surgery for Stanford type A acute aortic dissection from January 1997 through December 2007. The subjects were divided into two groups: patients who were discharged from the hospital, and those who died during hospitalization. Preoperative and operative clinical factors were compared between the groups. RESULTS: Overall, 41 patients (13.6%) died during hospitalization. On univariate analysis, significant preoperative risk factors for hospital mortality were cardiopulmonary resuscitation, coagulopathy, renal dysfunction, elevated aspartate aminotransferase levels, myocardial ischemia, and lower-extremity ischemia. As for factors related to surgery, the duration of operation, cardiopulmonary bypass time, aortic cross-clamp time, and volume of blood transfusion were greater among patients who died during hospitalization than in those who were discharged from the hospital. On multivariate analysis, independent preoperative risk factors were cardiopulmonary resuscitation, renal dysfunction, and lower-extremity ischemia. Shock or cardiac tamponade were not risk factors. CONCLUSIONS: Risk factors for hospital mortality in patients with Stanford type A acute aortic dissection were cardiopulmonary resuscitation, renal dysfunction, and lower-extremity ischemia.
BACKGROUND: Stanford type A acute aortic dissection is a fatal condition requiring emergency surgery. This study was designed to evaluate risk factors for hospital mortality in patients with Stanford type A acute aortic dissection. METHODS: We studied consecutive 301 patients (163 men and 138 women; mean age, 63.3 years) who underwent emergency surgery for Stanford type A acute aortic dissection from January 1997 through December 2007. The subjects were divided into two groups: patients who were discharged from the hospital, and those who died during hospitalization. Preoperative and operative clinical factors were compared between the groups. RESULTS: Overall, 41 patients (13.6%) died during hospitalization. On univariate analysis, significant preoperative risk factors for hospital mortality were cardiopulmonary resuscitation, coagulopathy, renal dysfunction, elevated aspartate aminotransferase levels, myocardial ischemia, and lower-extremity ischemia. As for factors related to surgery, the duration of operation, cardiopulmonary bypass time, aortic cross-clamp time, and volume of blood transfusion were greater among patients who died during hospitalization than in those who were discharged from the hospital. On multivariate analysis, independent preoperative risk factors were cardiopulmonary resuscitation, renal dysfunction, and lower-extremity ischemia. Shock or cardiac tamponade were not risk factors. CONCLUSIONS: Risk factors for hospital mortality in patients with Stanford type A acute aortic dissection were cardiopulmonary resuscitation, renal dysfunction, and lower-extremity ischemia.
Authors: Tyler M Gunn; Sotiris C Stamou; Nicholas T Kouchoukos; Kevin W Lobdell; Kamal Khabbaz; Lawrence H Patzelt; Robert C Hagberg Journal: Aorta (Stamford) Date: 2016-04-01
Authors: R Scott McClure; Maral Ouzounian; Munir Boodhwani; Ismail El-Hamamsy; Michael W A Chu; Zlatko Pozeg; Francois Dagenais; Khokan C Sikdar; Jehangir J Appoo Journal: Aorta (Stamford) Date: 2017-04-01
Authors: Paolo Berretta; Himanshu J Patel; Thomas G Gleason; Thoralf M Sundt; Truls Myrmel; Nimesh Desai; Amit Korach; Antonello Panza; Joe Bavaria; Ali Khoynezhad; Elise Woznicki; Dan Montgomery; Eric M Isselbacher; Roberto Di Bartolomeo; Rossella Fattori; Christoph A Nienaber; Kim A Eagle; Santi Trimarchi; Marco Di Eusanio Journal: Ann Cardiothorac Surg Date: 2016-07
Authors: Ahmet Kilic; Richard Tang; Bryan A Whitson; John H Sirak; Chittoor B Sai-Sudhakar; Juan Crestanello; Robert S D Higgins Journal: Interact Cardiovasc Thorac Surg Date: 2013-04-05