Outcomes of supra coronary aortic repair technique in patients with acute aortic dissection type A.

Abstract

Background: Acute aortic dissection type A (AADA) is a fatal event that requires an emergent surgical operation. Here, we decided to evaluate the outcome of supra coronary aortic repair technique in patients with type A acute aortic dissection for 16 years in Isfahan Chamran hospital that one surgeon performed.

Methods: This is a retrospective descriptive cross-sectional study performed in 2019 in Isfahan on documents of 54 patients who underwent supra-coronary repair surgery for type A aortic dissection during 2004 to 2019. We collected patient's demographic information, the condition of patient's vital signs at the time of admission to the hospital and before surgery, the cardiopulmonary bypass (CPB) time and other variables. We also collected data regarding patient's mortality and possible surgical complications.

Results: Evaluation of surgical complications showed that acute renal failure (ARF) was the most common complication (87%) followed by postoperative bleeding in ICU that required surgical operation (18.5%), neurologic complications (13%), acute respiratory distress syndrome (ARDS) (9.3%) and chronic renal failure (CRF) (1.9%). The mortality rate was 14.8% (8 patients). The most frequent reason for mortality was bleeding (50%), major neurologic complications (37.5%), multiple organ failure (25%), cardiac failure (12.5%) and CRF (12.5%). Patients with mortality had significantly higher age compared to other patients (P = 0.03), significantly higher duration of CPB use (P = 0.03), higher frequency of irregular peripheral pulses (P = 0.01), higher frequency of abnormal carotid pulses (P = 0.04), and higher bleeding volume in the ICU (P = 0.04).

Conclusion: Age, disturbed preoperative clinical condition, postoperative bleeding, and organ failure could increase the rates of mortality of AADA.