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Myocardial Priority Promotes Cardiovascular Recovery for Acute Type A Aortic Dissection Combined with Coronary Artery Disease Undergoing Aortic Arch Surgery

Duan, Lian ; Zhang, Chengliang ; Chen, Xuliang ; Wang, E ; Ye, Zhi ; Duan, Yanying ; Huang, Lingjin

Journal of personalized medicine, 2023-08, Vol.13 (9), p.1296 [Periódico revisado por pares]

Basel: MDPI AG

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Título:
Myocardial Priority Promotes Cardiovascular Recovery for Acute Type A Aortic Dissection Combined with Coronary Artery Disease Undergoing Aortic Arch Surgery
Autor: Duan, Lian ; Zhang, Chengliang ; Chen, Xuliang ; Wang, E ; Ye, Zhi ; Duan, Yanying ; Huang, Lingjin
Assuntos: Angina pectoris ; Aorta ; Aortic arch ; aortic arch surgery ; Aortic dissection ; blood conservation ; branch priority ; Cardiovascular disease ; Care and treatment ; Carotid arteries ; Coronary artery disease ; coronary artery stenosis ; Coronary heart disease ; Coronary vessels ; Creatinine ; Demographics ; Dissecting aneurysm ; Dissection ; Heart ; Heart diseases ; Hemoglobin ; Hospitals ; Ischemia ; Laboratories ; Morbidity ; Mortality ; myocardial protection ; Perfusion ; Precision medicine ; Surgery ; Surgical anastomosis ; type A dissection ; Vein & artery diseases
É parte de: Journal of personalized medicine, 2023-08, Vol.13 (9), p.1296
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
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Descrição: The optimal surgical strategy for acute type A aortic dissection (ATAAD) with coronary artery disease (CAD) remains unclear. The goal of this study was to investigate the cardiovascular protective effects of the myocardial priority (MP) strategy or traditional selective cerebral perfusion (SCP) in ATAAD with CAD. A total of 214 adults were analyzed retrospectively, of which 80 underwent the MP strategy intraoperatively. Seventy-nine pairs were propensity-score-matched and divided into SCP and MP groups. The follow-up period ranged from 6 to 36 months. The MP group had a significantly shorter myocardial ischemic time, higher perfusion flow, higher radial artery pressure, and lower incidence of NIRS decrease >20% of the base value, but a longer lower limb circulatory arrest and bypass time than the SCP group. Although similar adverse cardiac and cerebrovascular events were observed in both groups, a shorter posthospital stay, less blood loss and transfusion, higher postoperative hemoglobin, lower creatinine, and higher PaO2/FiO2 were observed in the MP group. Subgroup analysis showed that when the TIMI Risk Score was <4, the MP group had a lower incidence of low cardiac output and lower postoperative cTnI level. The follow-up patients had similar morbidities between the two groups. The novel MP strategy is associated with a shortened myocardial ischemic time, better maintained perfusion of vital organs, and postoperative recovery after surgery for ATAAD combined with non-severe CAD.
Editor: Basel: MDPI AG
Idioma: Inglês

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Myocardial Priority Promotes Cardiovascular Recovery for Acute Type A Aortic Dissection Combined with Coronary Artery Disease Undergoing Aortic Arch Surgery

Duan, Lian ; Zhang, Chengliang ; Chen, Xuliang ; Wang, E ; Ye, Zhi ; Duan, Yanying ; Huang, Lingjin

Basel: MDPI AG

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