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dc.contributor.authorPan, Emily
dc.contributor.authorWallinder, Andreas
dc.contributor.authorPeterström, Eric
dc.contributor.authorGeirsson, Arnar
dc.contributor.authorOlsson, Christian
dc.contributor.authorAhlsson, Anders
dc.contributor.authorFuglsang, Simon
dc.contributor.authorGunn, Jarmo
dc.contributor.authorHansson, Emma C
dc.contributor.authorHjortdal, Vibeke
dc.contributor.authorMennander, Ari
dc.contributor.authorNozohoor, Shahab
dc.contributor.authorWickbom, Anders
dc.contributor.authorZindovic, Igor
dc.contributor.authorGudbjartsson, Tomas
dc.contributor.authorJeppsson, Anders
dc.date.accessioned2019-11-21T12:53:34Z
dc.date.available2019-11-21T12:53:34Z
dc.date.issued2019-11
dc.date.submitted2019-11
dc.identifier.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.en_US
dc.identifier.issn1873-1570
dc.identifier.pmid31505231
dc.identifier.doi10.1016/j.resuscitation.2019.08.039
dc.identifier.urihttp://hdl.handle.net/2336/621192
dc.descriptionTo access publisher's full text version of this article click on the hyperlink belowen_US
dc.description.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.en_US
dc.description.sponsorshipSahlgrenska University Hospital Finnish Medical Foundation Turku University Foundationen_US
dc.language.isoenen_US
dc.publisherELSEVIER IRELANDen_US
dc.relation.urlhttps://www.sciencedirect.com/science/article/pii/S0300957219306045en_US
dc.subjectCardiac arresten_US
dc.subjectMalperfusionen_US
dc.subjectOutcomeen_US
dc.subjectType A aortic dissectionen_US
dc.subjectÓsæðargúllen_US
dc.subjectÆðaskurðlækningaren_US
dc.subjectHjartastoppen_US
dc.subject.meshAneurysm, Dissectingen_US
dc.subject.meshHeart Arresten_US
dc.titleOutcome after type A aortic dissection repair in patients with preoperative cardiac arrest.en_US
dc.typeArticleen_US
dc.contributor.department1 Department of Cardiothoracic Surgery, Heart Center, Turku University Hospital, Turku, Finland; Department of Surgery and Clinical Medicine, University of Turku, Turku, Finland. Electronic address: xiapan@utu.fi. 2 Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 3 Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden. 4 Department of Cardiothoracic Surgery, Faculty of Medicine, Landspitali University Hospital, University of Iceland, Reykjavik, Iceland; Section of Cardiac Surgery, Yale University School of Medicine, New Haven, CT, USA. 5 Department of Thoracic and Cardiovascular Surgery, Karolinska University Hospital, Stockholm, Sweden. 6 Department of Heart and Vascular Theme, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden. 7 Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Skejby, Denmark. 8 Department of Cardiothoracic Surgery, Heart Center, Turku University Hospital, Turku, Finland; Department of Surgery and Clinical Medicine, University of Turku, Turku, Finland. 9 Department of Cardiothoracic Surgery, Heart Center, Tampere University Hospital, Tampere, Finland. 10 Department of Clinical Sciences, Lund University, Skane University Hospital, Lund, Sweden; Department of Cardiothoracic Surgery, Lund University, Skåne University Hospital, Lund, Sweden. 11 Department of Cardiothoracic and Vascular Surgery, Orebro University Hospital, Orebro, Sweden; School of Health and Medicine, Orebro University, Orebro, Sweden. 12 Department of Cardiothoracic Surgery, Faculty of Medicine, Landspitali University Hospital, University of Iceland, Reykjavik, Iceland.en_US
dc.identifier.journalResuscitationen_US
dc.rights.accessNational Consortium - Landsaðganguren_US
dc.departmentcodeTAS12
dc.source.journaltitleResuscitation


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