Neurological Outcomes After Immediate Aortic Repair for Acute Type A Aortic Dissection Complicated by Coma
| Autor: | Kyoichi Ogawa, Ritsu Matsukawa, Toshihiro Kawahira, Tomonori Haraguchi, Taro Hayashi, Shuichi Kozawa, Yutaka Okita, Takuro Tsukube |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Consciousness Aortic aneurysm Cognition Aneurysm Physiology (medical) medicine Humans Glasgow Coma Scale Postoperative Period Coma Survival rate Stroke Aorta Aged Retrospective Studies Aged 80 and over Aortic dissection business.industry Retrospective cohort study Middle Aged medicine.disease Aortic Aneurysm Surgery Survival Rate Aortic Dissection Treatment Outcome Female medicine.symptom Cardiology and Cardiovascular Medicine business Vascular Surgical Procedures |
| Zdroj: | Circulation. 124 |
| ISSN: | 1524-4539 0009-7322 |
| Popis: | Background— Management of acute type A aortic dissection (AADA) complicated by coma remains controversial. We analyzed our experience in managing AADA complicated by coma to determine the relationship of duration of preoperative coma to postoperative neurological recovery. Methods and Results— Between September 2003 and October 2010, 181 patients with AADA were treated, including 27 presenting with coma (Glasgow Coma Scale 5 hours (delayed group). The preoperative National Institutes of Health Stroke Scale score was 31.4±6.6 in the immediate group and 28.3±9.5 in the delayed group. Hospital mortality was 14% in the immediate group and 67% in the delayed group. Full recovery of consciousness was achieved in 86% of patients in the immediate group and in 17% in the delayed group. In immediate group, the postoperative National Institutes of Health Stroke Scale score significantly improved to 6.4±8.4, cumulative survival rate was 71.8% in 3 years, and independence in daily activities was achieved in 52% (11/21). Conclusions— Aortic repair, if performed immediately from the onset of symptoms, showed satisfactory recovery of consciousness and neurological function in patients with AADA complicated by coma. In this patient population, immediate aortic repair is warranted. |
| Databáze: | OpenAIRE |
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