Outcomes of patients operated for acute type A aortic dissection requiring preoperative cardiopulmonary resuscitation

Autor: Mohammed Morjan, Carlos A. Mestres, Francesco Maisano, Vedran Savic, Diana Reser, Alberto Pozzoli
Přispěvatelé: University of Zurich, Morjan, Mohammed
Rok vydání: 2020
Předmět:
Male
Pulmonary and Respiratory Medicine
Resuscitation
medicine.medical_specialty
medicine.medical_treatment
610 Medicine & health
030204 cardiovascular system & hematology
2705 Cardiology and Cardiovascular Medicine
03 medical and health sciences
0302 clinical medicine
Preoperative Care
medicine
Humans
Cardiopulmonary resuscitation
Asystole
Aged
Retrospective Studies
Aortic dissection
business.industry
Mortality rate
Perioperative
Middle Aged
medicine.disease
Cardiopulmonary Resuscitation
10020 Clinic for Cardiac Surgery
2746 Surgery
Aortic Aneurysm
Cardiac Tamponade
Heart Arrest
Surgery
Survival Rate
Aortic Dissection
Treatment Outcome
030228 respiratory system
2740 Pulmonary and Respiratory Medicine
Acute Disease
Ventricular Fibrillation
Ventricular fibrillation
Pulseless electrical activity
Cardiology and Cardiovascular Medicine
business
Follow-Up Studies
Zdroj: Journal of Cardiac Surgery. 35:1425-1430
ISSN: 1540-8191
0886-0440
DOI: 10.1111/jocs.14586
Popis: BACKGROUND AND AIM Acute type A aortic dissection (AAAD) is a life-threatening condition. The emergency operation usually results in 20% perioperative mortality. If preoperative cardiopulmonary resuscitation (CPR) is necessary, there is an increase in the rate of mortality. The aim of the present study was to report the outcomes of AAAD surgery in patients requiring preoperative CPR in a high-volume center. METHODS A retrospective analysis of preoperative, intraoperative, postoperative, and follow-up data in patients requiring preoperative CPR in the setting of AAAD surgery was performed. RESULTS Between January 2006 and December 2018, 637 patients underwent emergency surgery for AAAD. In total, 26 (4%) patients received CPR; the mean age was 63 ± 13 years; and 18 were male (69%). The reason for CPR was acute tamponade (N = 14, 54%), pulseless electrical activity (N = 5, 19%), asystole or ventricular fibrillation (N = 7, 27%), and four (15%) patients were not operated due to prolonged CPR and severe initial neurological impairment. There was no intraoperative mortality. The in-hospital mortality rate was 50% (N = 11), due to severe cerebral damage confirmed by computed tomography, and six patients (55%) were older than 70 years. The median follow-up was 35 months (7-149), which was 100% complete; two patients had permanent hemiplegia, one had anterior spinal syndrome, and other two died during the follow-up. The overall survival rate was 41% (n = 9). CONCLUSION Surgery outcomes were still reasonable in AAAD patients requiring preoperative CPR in a high-volume center.
Databáze: OpenAIRE
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