Volume 20 Issue 1
Jan.  2022
Turn off MathJax
Article Contents
Article Navigation >  Chinese Journal of General Practice  > 2022  >  20(1): 18-21, 103
LI Yan-li, GAO Qing-yun, FENG Jun-bo, ZHANG Cheng-xin, GE Sheng-lin. The death risk factors of Stanford A aortic dissection surgery[J]. Chinese Journal of General Practice, 2022, 20(1): 18-21, 103. doi: 10.16766/j.cnki.issn.1674-4152.002266
Citation: LI Yan-li, GAO Qing-yun, FENG Jun-bo, ZHANG Cheng-xin, GE Sheng-lin. The death risk factors of Stanford A aortic dissection surgery[J]. Chinese Journal of General Practice, 2022, 20(1): 18-21, 103. doi: 10.16766/j.cnki.issn.1674-4152.002266
shu

The death risk factors of Stanford A aortic dissection surgery

doi: 10.16766/j.cnki.issn.1674-4152.002266

  • Department of Cardiovascular Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, China

Funds:

 1808085MH279

  • Received Date: 2020-05-16
    Available Online: 2022-03-03
    Abstract
  •   Objective  To explore the death risk factors after Stanford A aortic dissection surgery based on the perioperative data of patients with Stanford A aortic dissection.  Methods  A total of 68 patients with Stanford A aortic dissection from January 2012 to January 2020 were enrolled in the Cardiovascular Surgery Department of the First Affiliated Hospital of AnHui Medical University for the retrospective analysis. Based on clinical outcome, patients were divided into survival group (n=50) and death group (n=18). The preoperative, intraoperative and postoperative clinical data was summarized and studied retrospectively. Univariate analysis was performed by t/χ2 test and further, multivariate analysis was performed by logistic regression based on significant results from univariate analysis to identify the death risk factors after Stanford A aortic dissection surgery.  Results  There were significant differences between two groups by univariate analysis for preoperative LVEF < 50%, preoperative hypotension, preoperative pericardial effusion, preoperative neurological disorder, involved coronary arteries, involved aortic valve, intraoperative lactic acid, ultrafiltration, urine volume and supportive cardiopulmonary by pass running time (all P < 0.05). Subsequently, preoperative LVEF < 50% (OR=33.163, P=0.037) and supportive cardiopulmonary bypass running time (OR=1.248, P=0.004) were significant factors by logistic regression analysis. Postoperatively, there were significant differences for extubation time, reoperation, re-intubation, awaking time, CRRT, postoperative lactic acid and ICU stay (all P < 0.05).  Conclusion  Both preoperative LVEF < 50% and supportive cardiopulmonary bypass running time are the death risk factors of Stanford A aortic dissection surgery.

     

    • FullText(HTML)
  • loading
    • References(20)
  • [1]
    OKITA Y, MIYATA H, MOTOMURAN N, et al. A study of brain protection during total arch replacement comparing antegrade cerebral perfusion versus hypothermic circulatory arrest, with or without retrograde cerebral perfusion: Analysis based on the Japan Adult Cardiovascular Surgery Database[J]. J Thorac Cardiovasc Surg, 2015, 149(2): 65-67. doi: 10.1016/j.jtcvs.2014.08.070
    [2]
    TRIMARCHI S, NIENABER C A, RAMPOLDI V, et al. Contemporary results of surgery in acute type A aortic dissection: The International Registry of Acute Aortic Dissection experience[J]. J Thorac Cardiovasc Surg, 2005, 129(1): 112-122. doi: 10.1016/j.jtcvs.2004.09.005
    [3]
    MESZAROS I, MOROCZ J, SZLAVI J, et al. Epidemiology and clinicopathology of aortic dissection[J]. Chest, 2000, 117(5): 1271-1278. doi: 10.1378/chest.117.5.1271
    [4]
    EVANGELISTA A, ISSELBACHER E M, BOSSONE E, et al. Insights From the international registry of acute aortic dissection: A 20-Year experience of collaborative clinical research[J]. Circulation, 2018, 137(17): 1846-1860. doi: 10.1161/CIRCULATIONAHA.117.031264
    [5]
    TSAI T T, TRIMARCHI S, NIENAABER C A. Acute aortic dissection: Perspectives from the International Registry of Acute Aortic Dissection (IRAD)[J]. Eur J Vasc Endovasc Surg, 2008, 37(2): 149-159.
    [6]
    IMOTO K, UCHIDA K, KARUBE N, et al. Risk analysis and improvement of strategies inpatients who have acute type A aortic dissection with coronary artery dissection[J]. Eur J Cardiothorac Surg, 2013, 44(3): 419-424. doi: 10.1093/ejcts/ezt060
    [7]
    张明明, 伊力哈木江·克尤木, 吴元元, 等. Stanford A型主动脉夹层急诊行外科手术治疗的临床探讨[J]. 中华急诊医学杂志, 2016, 25(1): 79-82. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHHL201805013.htm
    [8]
    TEO L Y, CHAN L L, LAM C S. Heart failure with preserved ejection fraction in hypertension[J]. Curr Opin Cardiol, 2016, 31(4): 410-416. doi: 10.1097/HCO.0000000000000292
    [9]
    丁绍祥, 张乐, 高云涛, 等. 左心室射血分数与心电图QRS波时程比值对老年心力衰竭患者心功能的评估[J]. 中华老年心脑血管病杂志, 2019, 21(8): 801-803. doi: 10.3969/j.issn.1009-0126.2019.08.005
    [10]
    李志超, 王传合, 孙志军. 射血分数保留型心力衰竭患者入院血红蛋白浓度与出院后心衰易损期发生联合终点事件的关系[J]. 山东医药, 2020, 60(6): 72-75. https://www.cnki.com.cn/Article/CJFDTOTAL-SDYY202006018.htm
    [11]
    贺继刚, 李洪荣, 李永武, 等. 急性Stanford A型主动脉夹层动脉瘤手术死亡风险因素研究[J]. 中国全科医学, 2017, 20(10): 1196-1199. doi: 10.3969/j.issn.1007-9572.2017.10.011
    [12]
    李军, 周荟, 李红艳, 等. 重度全身炎性反应综合征对全主动脉弓置换术后早期临床结局的影响[J]. 中国分子心脏病学杂志, 2018, 18(1): 2339-2341. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGFB201801003.htm
    [13]
    BERRETTA P, TRIMACHI S, PATEL H J, et al. Malperfusionsyndromes in type A aortic dissection: What we have learned from IRAD[J]. J Vis Surg, 2018, 10(4): 65-72.
    [14]
    NARAYAN P, ROGERS C A, BENEDETTO U, et al. Malperfusion rather than merely timing of operative repair determines early and late outcome in type A aortic dissection[J]. J Thorac Cardiovasc Surg, 2017, 154(1): 81-86. doi: 10.1016/j.jtcvs.2017.03.041
    [15]
    胡知朋, 张敏, 王志维, 等. 急性A型主动脉夹层合并腹腔脏器灌注不良的治疗[J]. 实用医学杂志, 2017, 33(23): 4011-4012. doi: 10.3969/j.issn.1006-5725.2017.23.042
    [16]
    张莉莉, 王效增, 刘艳杰, 等. 急性降主动脉夹层合并冠心病患者临床特点与危险因素分析[J]. 临床军医杂志, 2017, 45(6): 584-588. https://www.cnki.com.cn/Article/CJFDTOTAL-JYGZ201706008.htm
    [17]
    赵明明, 郭子健, 孙雨薇, 等. 急性A型主动脉夹层的累及特性与术后重度急性肾损伤的关系[J]. 心肺血管病杂志, 2019, 38(7): 741-746, 760. doi: 10.3969/j.issn.1007-5062.2019.07.007
    [18]
    胡知朋, 张敏, 王志维, 等. 急性A型主动脉夹层合并腹腔脏器灌注不良的治疗[J]. 实用医学杂志, 2017, 33(23): 4011-4012. doi: 10.3969/j.issn.1006-5725.2017.23.042
    [19]
    韩晓霞, 韩萍, 李瑞枝. 心脏瓣膜置换患者围手术期医院感染的预防[J]. 中华医院感染学杂志, 2014, 24(14): 3547-3548, 3559. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHYY201414064.htm
    [20]
    刘菁菁, 张菁, 贺茂林. 老年急性脑梗死合并肺部感染患者的危险因素和预后相关性研究[J]. 中华老年心脑血管病杂志, 2011, 13(9): 824-826. https://www.cnki.com.cn/Article/CJFDTOTAL-LNXG201109023.htm
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Tables(4)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (387) PDF downloads(9) Cited by()
    Proportional views
    Related

    Address：No. 287, Changhuai Road, Bengbu, Anhui Province, 233004, P.R.ChinaphoneNo：0552-3066635； 0552-3051890Email：zhqkyx@163.com

    Copyright © Chinese Journal of General Practice皖ICP备2020018345号-2

    Supported by: Beijing Renhe Information Technology Co., Ltd.    

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return