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Renal malperfusion affects operative mortality rather than late death following acute type A aortic dissection repair

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收录情况: ◇ SCIE

机构: [1]Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing Engineering Research Center of Vascular Prostheses, Beijing, China
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关键词: Aortic arch Aortic dissection/type A/acute Mortality Outcomes Renal malperfusion Surgery

摘要:
Objective: The aim of our study was to assess how much renal malperfusion increases the risk of early and late mortality in patients with acute type A aortic dissection (ATAAD) undergoing surgical repair. Methods: This study included 218 patients with ATAAD undergoing surgical repair using the total arch replacement and frozen elephant trunk technique. Mean age was 47.8 ± 10.7 years and 170 were male (78.0%). Based on clinical symptoms and computed tomographic angiography (CTA) findings, 48 patients were diagnosed with preoperative renal malperfusion (22.0%). Clinical data were compared between two groups. The impact of renal malperfusion on operative and late mortality were evaluated with Cox regression. Results: Patients with renal malperfusion experienced significantly higher incidences of persistent postoperative acute kidney injury (AKI; 10/48, 20.8% vs 7/170, 4.1%; p < 0.001) and transient AKI (10/48, 20.8% vs 8/170, 4.7%; p = 0.001) as well as operative mortality (22.9%, 11/48 vs 8.3%, 14/170; p = 0.023). Five-year survival was significantly lower in the renal malperfusion group (72.9% vs 87.0%, p = 0.003). Renal malperfusion was the risk factor for operative mortality (hazard ratio, HR, 2.74; 95% CI, 1.07–6.99; p = 0.035) and overall mortality (HR, 2.64; 95% CI, 1.23–5.67; p = 0.013) but did not predict late death (HR, 2.46; 95% CI, 0.65–9.35; p = 0.187). Conclusion: Renal malperfusion increases the risk of operative mortality by 3 times but did not affect late death in patients undergoing acute type A dissection repair. © 2019

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出版当年[2018]版:
大类 | 4 区 医学
小类 | 4 区 外科
最新[2023]版:
大类 | 3 区 医学
小类 | 3 区 外科
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出版当年[2017]版:
Q2 SURGERY
最新[2023]版:
Q1 SURGERY

影响因子: 最新[2023版] 最新五年平均 出版当年[2017版] 出版当年五年平均 出版前一年[2016版] 出版后一年[2018版]

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第一作者机构: [1]Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing Engineering Research Center of Vascular Prostheses, Beijing, China
通讯作者:
通讯机构: [1]Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing Engineering Research Center of Vascular Prostheses, Beijing, China [*1]Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
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