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- W2318505198 abstract "Ascending aortic dissection is a lethal disease requiring emergent surgical treatment. This study describes the characteristics of patients presenting with acute ascending aortic dissection and identifies risk factors for postoperative morbidity and mortality. From July 1994 to February 2010, Sixty-six patients underwent ascending aortic replacement for acute type A dissection in our institution. A retrospective review of individual patient files was conducted and analysis was performed to identify risk factors for morbidity and mortality. The cohort was composed of 39 (59.1%) males and 27 (40.9%) females (mean age was 61.2 ± 14.4 years). Mean additive and logistic euroSCORES were 11.2 ± 3.6 and 31.0 ± 21.4, respectively. Thirty-five (53.0%) patients presented with chest pain alone, while 23 (34.8%) patients presented with complicated aortic dissection, including neurologic or ischemic symptoms, or hypotension. The remaining eight (12.2%) dissections were of iatrogenic etiology. Hemodynamic instability was noted in 18 patients (27.3%), at initial presentation, and hemopericardium or hemothorax was found in 30 (45.5%). Arterial axillary cannulation was performed in 25 patients (37.9%), femoral cannulation in 27 (40.9%), and ascending aorta cannulation in 14 (21.2%). Acute renal failure (ARF) and postoperative infection were identified in 33.3% and 22.7% of patients, respectively. Advanced age was associated with contained rupture (p<0.05), atrial fibrillation (p=0.05), ARF (p<0.05) and prolonged (>24H) postoperative vasopressor use (p<0.05). Overall mortality was 24.2%. Hemodynamic instability at presentation (p=0.003) and preoperative rupture (p<0.05) were associated with increased mortality, whereas axillary cannulation had a protective effect (8.7% vs 51.9% for other cannulation sites) (p=0.016). Surgery for acute type A aortic dissection is associated with significant morbidity and mortality. These results suggest that older age, hemodynamic instability, and contained rupture at presentation increase operative risks, while axillary artery cannulation is associated with better outcomes." @default.
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- W2318505198 date "2012-09-01" @default.
- W2318505198 modified "2023-09-25" @default.
- W2318505198 title "160 Surgery For Type A Aortic Dissection: Results Over 15 Years" @default.
- W2318505198 doi "https://doi.org/10.1016/j.cjca.2012.07.163" @default.
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