Outcome after type A aortic dissection repair in patients with preoperative cardiac arrest.
Cast your vote
You can rate an item by clicking the amount of stars they wish to award to this item.
When enough users have cast their vote on this item, the average rating will also be shown.
Your vote was cast
Thank you for your feedback
Thank you for your feedback
Hansson, Emma C
MetadataShow full item record
CitationPan E, Wallinder A, Peterström E, Geirsson A, Olsson C, Ahlsson A, Fuglsang S, Gunn J, Hansson EC, Hjortdal V, Mennander A. Outcome after type A aortic dissection repair in patients with preoperative cardiac arrest. Resuscitation. 2019 Nov 1;144:1-5. doi: 10.1016/j.resuscitation.2019.08.039.
AbstractAIM OF THE STUDY: Patients presenting with acute type A aortic dissection (ATAAD) and cardiac arrest before surgery are considered to have very poor prognosis, but limited data is available. We used a large database to evaluate the outcome of ATAAD patients with a cardiac arrest before surgery. METHODS: We evaluated 1154 surgically treated ATAAD patients from the Nordic Consortium for Acute Type A Aortic Dissection (NORCAAD) database between 2005 and 2014. Patients with (n = 44, 3.8%) and without preoperative cardiac arrest were compared and variables univariably associated with mortality in the cardiac arrest group were identified. Median follow-up time was 2.7 years (interquartile range 0.5-5.5). RESULTS: Thirty-day mortality in the arrest and non-arrest group was 43.2% and 16.6%, respectively (odds ratio [OR] 3.83, CI 2.06-7.09; P < 0.001). In the nine patients with ongoing cardiopulmonary resuscitation when cardiopulmonary bypass was initiated, five died intraoperatively and one died after 65 days. In patients surviving the operation, stroke was significantly more common in the arrest group (48.4% vs 18.2%; OR 4.21, CI 2.05-8.67; P < 0.001). In total, 50.0% (22/44) of the arrest patients survived to the end of follow-up. Non-survivors in the arrest group more often had DeBakey type I dissection, cardiac tamponade, cardiac malperfusion and higher preoperative serum lactate (all P < 0.05). CONCLUSIONS: Early mortality and complications after ATAAD surgery in patients with a preoperative cardiac arrest are high, but mid-term outcome after surviving the initial period is acceptable. Preoperative cardiac arrest should not be considered an absolute contraindication for a surgical ATAAD repair.
DescriptionTo access publisher's full text version of this article click on the hyperlink below
- Malperfusion in acute type A aortic dissection: An update from the Nordic Consortium for Acute Type A Aortic Dissection.
- Authors: Zindovic I, Gudbjartsson T, Ahlsson A, Fuglsang S, Gunn J, Hansson EC, Hjortdal V, Järvelä K, Jeppsson A, Mennander A, Olsson C, Pan E, Sjögren J, Wickbom A, Geirsson A, Nozohoor S
- Issue date: 2019 Apr
- The Nordic Consortium for Acute type A Aortic Dissection (NORCAAD): objectives and design<sup/>.
- Authors: Geirsson A, Ahlsson A, Franco-Cereceda A, Fuglsang S, Gunn J, Hansson EC, Hjortdal V, Jarvela K, Jeppsson A, Mennander A, Nozohoor S, Olsson C, Wickbom A, Zindovic I, Gudbjartsson T
- Issue date: 2016 Oct - Dec
- Evaluation of risk factors for transient neurological dysfunction and adverse outcome after repair of acute type A aortic dissection in 122 consecutive patients.
- Authors: Haldenwang PL, Wahlers T, Himmels A, Wippermann J, Zeriouh M, Kröner A, Kuhr K, Strauch JT
- Issue date: 2012 Nov
- Extended repair for acute type A aortic dissection: long-term outcomes of the frozen elephant trunk technique beyond 10 years.
- Authors: Ma WG, Chen Y, Zhang W, Li Q, Li JR, Zheng J, Liu YM, Zhu JM, Sun LZ
- Issue date: 2020 Jun
- Cerebral perfusion issues in acute type A aortic dissection without preoperative malperfusion: how do surgical factors affect outcomes?
- Authors: Buonocore M, Amarelli C, Scardone M, Caiazzo A, Petrone G, Majello L, Santé P, Nappi G, Della Corte A
- Issue date: 2016 Oct