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Early and late risk factors in surgical treatment of acute type A aortic dissection

Pansini, Stefano ; Gagliardotto, Pier Vincenzo ; Pompei, Esmeralda ; Parisi, Francesco ; Bardi, Gianluca ; Castenetto, Enzo ; Orzan, Fulvio ; di Summa, Michele

The Annals of thoracic surgery, 1998-09, Vol.66 (3), p.779-784 [Periódico revisado por pares]

New York, NY: Elsevier Inc

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Título:
Early and late risk factors in surgical treatment of acute type A aortic dissection
Autor: Pansini, Stefano ; Gagliardotto, Pier Vincenzo ; Pompei, Esmeralda ; Parisi, Francesco ; Bardi, Gianluca ; Castenetto, Enzo ; Orzan, Fulvio ; di Summa, Michele
Assuntos: Adult ; Aged ; Aneurysm, Dissecting - mortality ; Aneurysm, Dissecting - surgery ; Aortic Aneurysm - mortality ; Aortic Aneurysm - surgery ; Biological and medical sciences ; Blood and lymphatic vessels ; Cardiac Surgical Procedures ; Cardiology. Vascular system ; Diseases of the aorta ; Female ; Hospital Mortality ; Humans ; Male ; Medical sciences ; Middle Aged ; Postoperative Complications ; Prognosis ; Retrospective Studies ; Risk Factors ; Survival Analysis ; Treatment Outcome
É parte de: The Annals of thoracic surgery, 1998-09, Vol.66 (3), p.779-784
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
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Descrição: Background. Morbidity and mortality of emergency repair of type A dissecting aneurysms of the aorta are high. This is an attempt to investigate the risk determinants of early and late results. Methods. A series of preoperative and operative variables were retrospectively collected from the clinical records of 291 patients operated on between January 1, 1979, and December 31, 1995. Risk factors for surgical death were investigated with univariate analysis and stepwise logistic regression. Follow-up was conducted between December 1995 and February 1996. Analysis of late results was conducted by means of actuarial survival curves (life method). After removing the surgical deaths, risk factors for late deaths were analyzed by a Cox model. Results. The in-hospital mortality rate was 36.1%. Significant independent determinants of operative or early death were preoperative shock, preoperative neurologic impairment, operation before 1986, perioperative bleeding, and prolonged clamping time. The 10-year survival rate was 36.9% ± 4.4%. Twenty-six patients required repeat operation. The long-term prognosis was significantly worse in patients who needed reoperation. Conclusions. Growing awareness of this disease and quicker diagnosis have increased the number of patients with acute dissection of the ascending aorta who are taken early to operation. This new challenge must be met by better preoperative support and intraoperative monitoring, and by surgical techniques that focus on lowering the rate of late complications, for which lifelong follow-up must be provided.
Editor: New York, NY: Elsevier Inc
Idioma: Inglês

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Early and late risk factors in surgical treatment of acute type A aortic dissection

Pansini, Stefano ; Gagliardotto, Pier Vincenzo ; Pompei, Esmeralda ; Parisi, Francesco ; Bardi, Gianluca ; Castenetto, Enzo ; Orzan, Fulvio ; di Summa, Michele

New York, NY: Elsevier Inc

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