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Effect on surgery outcomes owing to the interval between onset of symptoms and surgery of patients with acute type A aortic dissection

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Emergency and Critical Care Medicine 2022年第2期2卷 67-72页

作者： Shouming Li Duoliang Wei Zhenhua Wang Han Song Shaopeng Cheng Xin Zhao Department of Cardiovascular Surgery Qilu Hospital of Shandong UniversityJinanShandongChina

Background:This study aimed to identify whether the interval from onset of symptoms to surgery affects the outcomes of surgery in patients with acute type A aortic dissection(AAAD).Methods:This study retrospectively examined 249 patients with AAAD who underwent Sun’s *** patients were divided into 2 groups,hyperacute and acute,according to the interval from onset of symptoms to *** primary endpoint was all-cause early mortality,and the secondary endpoint was early ***:The surgery time,cardiopulmonary bypass time,clamp time,and selective cerebral perfusion time were not significantly different between the 2 *** intensive care unit length of stay and duration of mechanical ventilation of the 2 groups were 185.50hours versus 185.00hours(P=0.970)and 41.50hours versus 44.00hours(P=0.678),*** were 52 early deaths:29 in the hyperacute group and 23 in the acute group(21.6%vs.20.0%,P=0.751).The incidence of reoperation was 0.7% and 0.9%(P>0.999),*** incidence rates of postoperative acute heart failure(AHF),acute respiratory failure(ARF),nervous dysfunction,and acutekidney injury were37.3% versus 25.2%(P=0.041),51.5%versus51.3%(P=0.976),13.4% versus 7.0%(P=0.096),and 37.3% versus 37.4%(P=0.990),*** analysis indicated that surgery in the hyperacute phase might be an independent risk factor for AHF(OR:1.765;95%CI:1.021–3.052;P=0.042).Conclusion:Surgery in the hyperacute phase of AAAD was associated with postoperative ***,early medical management or interventional therapy for complications before surgery performed by experienced surgeons is recommended,especially in the hyperacute phase.

关键词： Acute type A aortic dissection Hyperacute phase stented elephant Total arch replacement

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