[To Improve the Results of Surgery for Stanford Type A Acute Aortic Dissection:Strategy for Organ Malperfusion].

Autor:	Maze Y; Department of Thoracic and Cardiovascular Surgery, Ise Red Cross Hospital, Ise, Japan., Tokui T, Murakami M, Kawaguchi T, Inoue R, Hirano K
Jazyk:	japonština
Zdroj:	Kyobu geka. The Japanese journal of thoracic surgery [Kyobu Geka] 2021 Apr; Vol. 74 (4), pp. 248-255.
Abstrakt:	Objectives: We presented the results of surgery for Stanford type A acute aortic dissection at our hospital and described strategies for organ malperfusion (especially brain malperfusion). Results: From January 2012 to December 2019, we underwent 174 patients of Stanford type A acute aortic dissection at our hospital. There were 47 patients( 27.0%) with postoperative cerebral infarction (stroke group). Compared to the non-stroke group, the stroke group had significantly more cases of persistent central nervous system malperfusion before surgery and had more intraoperative bleeding and blood transfusion. The hospital mortality was 23.4% in the stroke group and 3.9% in the non-stroke group( p<0.001). As a result of multivariate analysis, risk factors for hospital mortality were preoperative endotracheal intubation, long-term cardiopulmonary bypass time and postoperative stroke. The risk factor for postoperative stroke was preoperative central nervous system malperfusion. Conclusions: As a strategy for cerebral malperfusion, it is useful to use the right axillary artery blood supply and the isolated cerebral perfusion method.
Databáze:	MEDLINE
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