scholarly journals Surgical treatment of type A acute aortic dissection with cerebral malperfusion: a systematic review

2021 ◽  
Author(s):  
Changtian Wang ◽  
LEI ZHANG ◽  
tao li ◽  
Zhilong Xi ◽  
Haiwei Wu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Surgical Treatment ◽  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
Surgical Repair ◽  
Type A ◽  
Mortality And Morbidity ◽  
Medline Search ◽  
Cerebral Malperfusion

Purpose: Type A acute aortic dissection (TAAAD) complicated with cerebral malperfusion (CM) is a life-threatening condition associated with high mortality, poor outcomes, and the optimal surgical management remains controversial. The aim of this review was to report the current results of surgical interventions of these patients. Methods: A systematic review was performed using PubMed and MEDLINE search for cases underwent surgical repair for TAAAD with CM. Demographics, neurological symptom, the time from onset of symptoms to operation, operation data, mortality, neurological outcome, and follow-up were reviewed. Results: A total of 363 patients with mean age of 65.7±13 years underwent surgical repair for TAAAD with CM were identified in 12 retrospective studies. In-hospital mortality was 20.1%. Mean duration of follow-up was 40.1 ± 37.6 months. The involved supra-aortic branch vessels were RCCA (n=99), LCCA (n=25) , B-CCA (n=52), CCA (n=131), IA (n=19), and LSA (n=8). Time from onset of neurological symptoms to surgery was 13.3 hours. Antegrade and/or retrograde cerebral perfusion was applied. Postoperatively, improved, unchanged and worsened neurological status was occurred in 54.3%, 27.1%, and 8.5%, respectively in 199 patients. Conclusion: The outcomes of surgical treatment of TAAAD complicated with CM indicate acceptable early mortality and morbidity. It is reasonable to perform lifesaving surgery on these patients. Early central surgical repair and reperfusion of brain may improve the outcomes.

scholarly journals Surgical Treatment of Acute Type A Aortic Dissection with 18-Litre Bleeding

Aorta ◽  
2021 ◽  
Vol 09 (01) ◽  
pp. 030-032
Author(s):  
Sergey Y. Boldyrev ◽  
Kirill O. Barbukhatty ◽  
Vladimir A. Porhanov
Keyword(s):  
Surgical Treatment ◽  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
Type A ◽  
Type I ◽  
Acute Type ◽  
Drug Induced ◽  
Type A Aortic Dissection ◽  
Mortality And Morbidity ◽  
Perioperative Bleeding

AbstractSurgical treatment of Type-A acute aortic dissection is associated with high mortality and morbidity. One of the reasons is perioperative bleeding, which may lead to worse outcomes. We present a case of successful treatment of a patient with 18-litre perioperative blood loss in DeBakey Type-I acute aortic dissection with drug-induced hypocoagulation and malperfusion of a lower extremity.

scholarly journals Italian multicentre study on type A acute aortic dissection: a 33-year follow-up

2015 ◽  
Vol 49 (1) ◽  
pp. 125-131 ◽  
Author(s):  
Claudio F. Russo ◽  
Giovanni Mariscalco ◽  
Andrea Colli ◽  
Pasquale Santè ◽  
Francesco Nicolini ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Multicentre Study ◽  
Acute Aortic Dissection ◽  
Type A

scholarly journals Surgical Treatment of Proximal Aortic Dissection in Patients with Stanford Type A Acute Aortic Dissection

2013 ◽  
Vol 42 (4) ◽  
pp. 251-254
Author(s):  
Tetsuro Uchida ◽  
Cholsu Kim ◽  
Yoshiyuki Maekawa ◽  
Eiichi Oba ◽  
Ken Nakamura ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
Type A

scholarly journals Lower body ischaemic time is a risk factor for acute kidney injury after surgery for type A acute aortic dissection

2019 ◽  
Vol 30 (1) ◽  
pp. 107-112 ◽  
Author(s):  
Kentaro Amano ◽  
Yoshiyuki Takami ◽  
Hiroshi Ishikawa ◽  
Michiko Ishida ◽  
Masato Tochii ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
Surgical Repair ◽  
Kidney Injury ◽  
Type A ◽  
Hospital Death ◽  
Lower Body ◽  
Postoperative Aki

Abstract OBJECTIVES Postoperative acute kidney injury (AKI) is known as a risk factor for death after surgery for Stanford type A acute aortic dissection under hypothermic circulatory arrest. It may also adversely affect long-term survival. We searched for modifiable risk factors for postoperative AKI, focusing on lower body ischaemic time. METHODS We reviewed 191 patients undergoing surgical repair for Stanford type A acute aortic dissection. The distal anastomosis depended on excluding the primary tear location, resulting in ascending/hemiarch (n = 119), partial arch (n = 18) and total arch replacement (n = 54). We defined an increase in the serum creatinine level to ≧2 times the baseline level as AKI. The incidence of AKI was investigated with multivariate analysis of its risk factors. RESULTS Postoperative AKI was observed in 49 patients (26%), 31% of whom required renal replacement therapy. The overall hospital mortality rate was 8.5%. Postoperative AKI, preoperative shock and organ malperfusion were predictors of hospital death. Multivariate stepwise logistic regression analysis identified age, body mass index, preoperative chronic kidney disease and lower body ischaemic time as risk factors for postoperative AKI. CONCLUSIONS Although surgical repair for Stanford type A acute aortic dissection showed favourable results, the incidence of postoperative AKI is still high, closely associated with hospital death. Lower body ischaemic time should be recognized specifically as a modifiable surgical risk factor for postoperative AKI.

scholarly journals Surgical treatment of type A Acute Aortic Dissection based on Geneva algorithm

2015 ◽  
Vol 10 (S1) ◽  
Author(s):  
Burak Can Depboylu ◽  
Leon Finci ◽  
Patrick O Myers ◽  
Saziye Karaca ◽  
Dominique Vala ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
Type A

Present-day policy of surgical treatment for type A acute aortic dissection

2020 ◽  
Vol 26 (3) ◽  
pp. 82
Author(s):  
Rukosujew ◽  
M. V. Usai ◽  
Martens ◽  
Ibrahim ◽  
Shakaki ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
Type A
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