期刊
EUROPEAN HEART JOURNAL
卷 26, 期 2, 页码 180-186出版社
OXFORD UNIV PRESS
DOI: 10.1093/eurheartj/ehi024
关键词
aortic dissection; aorta; surgery
Aims The purpose of this retrospective study was to assess the risk factors for the early and late outcome of the surgical treatment of acute type A aortic dissection, in terms of mortality and morbidity. Methods and results From 1976 to 2003, 487 patients with acute type A aortic dissection treated surgically were enrolled. Twenty-five pre-operative and intra-operative variables were analysed to identify conditions influencing early and late morbidity and early mortality. The in-hospital mortality rate including operative death was 22 % (1017 patients). Multivariable analysis indicated that pre-existing cardiac disease (RR = 3.7, 95 % Cl = 1.8-7.4) and cardiopulmonary resuscitation (RR = 6.8, 95 % CI = 23-20.2) were independent predictors of in-hospital death. The causes of in-hospital mortality were tow cardiac output in 32 patients (6.6 %), major brain damage in 24 patients (5.9 %), haemorrhage in 11 patients (2.2 %), sepsis in nine patients (1.8 %), visceral ischaemia in eight patients (1.6 %), multiple organ failure in seven patients (1.4 %), rupture of the thoracic aorta in six patients (1.2 %), respiratory failure in six patients (1.2 %), and four intra-operative deaths. The follow-up was 100 % complete. The actuarial survival was 94.9 +/- 1.2 % and 88.1 +/- 2.6 %, at 5 and 10 years, respectively. Conclusions Patients' pre-operative co-morbidities and dissection-related complications significantly affect early and late survival and morbidity after surgical treatment of acute type A aortic dissection.
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