Evaluation of Acute Aortic Dissection Type a Factors and Comparison the Postoperative Clinical Outcomes between Two Surgical Methods
Background: Although aortic dissection is a rare disease, it causes high level of mortality. If ascending aorta gets involved in this disease, it is known as type A. According to small number of studies about this disease in Iran, this study conducted to detect the factors related to acute aortic di...
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doaj-efea415b88f1427daa2d3cb077bcb94b2020-11-25T00:14:25ZengWolters Kluwer Medknow PublicationsAdvanced Biomedical Research2277-91752017-01-0161858510.4103/2277-9175.210662Evaluation of Acute Aortic Dissection Type a Factors and Comparison the Postoperative Clinical Outcomes between Two Surgical MethodsHasan ShemiraniAmir MirmohamadsadeghiBehzad MahakiSadaf FarhadiReza Mohseni BadalabadiPeyman BidramMehdi Mohseni BadalabadiBackground: Although aortic dissection is a rare disease, it causes high level of mortality. If ascending aorta gets involved in this disease, it is known as type A. According to small number of studies about this disease in Iran, this study conducted to detect the factors related to acute aortic dissection type A, its surgery consequences and the factors affecting them. Materials and Methods: In this historical cohort study, all patients having acute aortic dissection type A referring to Chamran Hospital from 2006 to 2012 were studied. The impact of two surgical methods including antegrade cerebral perfusion (ACP) and retrograde cerebral one (RCP) on surgical and long-term mortality and recurrence of dissection was determined. The relation of mortality rate and hemodynamic instability before surgery, age more than 70 years old, ejection fraction lower than 50%, prolonged cardiopulmonary bypass pump (CPBP) time and excessive blood transfusion, was assessed. Results: Surgery and long-term mortality and recurrence of dissection were 35.3%, 30.8% and 30.4%. Surgical and long-term death in the patients being operated by ACP method was lower than those one being operated by RCP (P < 0.001). Excessive blood transfusion and unstable hemodynamic condition had significant effect on surgical mortality (P = 0.014, 0.030, respectively). CPBP time and unstable hemodynamic condition affected long-term mortality significantly (P = 0.002). Conclusion: The result found that ACP is the preferable kind of surgery in comparison with RCP according to the surgical and long-term mortality.http://www.advbiores.net/article.asp?issn=2277-9175;year=2017;volume=6;issue=1;spage=85;epage=85;aulast=ShemiraniAcute aortic dissection type Aantegrade cerebral perfusionretrograde cerebral perfusion |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Hasan Shemirani Amir Mirmohamadsadeghi Behzad Mahaki Sadaf Farhadi Reza Mohseni Badalabadi Peyman Bidram Mehdi Mohseni Badalabadi |
spellingShingle |
Hasan Shemirani Amir Mirmohamadsadeghi Behzad Mahaki Sadaf Farhadi Reza Mohseni Badalabadi Peyman Bidram Mehdi Mohseni Badalabadi Evaluation of Acute Aortic Dissection Type a Factors and Comparison the Postoperative Clinical Outcomes between Two Surgical Methods Advanced Biomedical Research Acute aortic dissection type A antegrade cerebral perfusion retrograde cerebral perfusion |
author_facet |
Hasan Shemirani Amir Mirmohamadsadeghi Behzad Mahaki Sadaf Farhadi Reza Mohseni Badalabadi Peyman Bidram Mehdi Mohseni Badalabadi |
author_sort |
Hasan Shemirani |
title |
Evaluation of Acute Aortic Dissection Type a Factors and Comparison the Postoperative Clinical Outcomes between Two Surgical Methods |
title_short |
Evaluation of Acute Aortic Dissection Type a Factors and Comparison the Postoperative Clinical Outcomes between Two Surgical Methods |
title_full |
Evaluation of Acute Aortic Dissection Type a Factors and Comparison the Postoperative Clinical Outcomes between Two Surgical Methods |
title_fullStr |
Evaluation of Acute Aortic Dissection Type a Factors and Comparison the Postoperative Clinical Outcomes between Two Surgical Methods |
title_full_unstemmed |
Evaluation of Acute Aortic Dissection Type a Factors and Comparison the Postoperative Clinical Outcomes between Two Surgical Methods |
title_sort |
evaluation of acute aortic dissection type a factors and comparison the postoperative clinical outcomes between two surgical methods |
publisher |
Wolters Kluwer Medknow Publications |
series |
Advanced Biomedical Research |
issn |
2277-9175 |
publishDate |
2017-01-01 |
description |
Background: Although aortic dissection is a rare disease, it causes high level of mortality. If ascending aorta gets involved in this disease, it is known as type A. According to small number of studies about this disease in Iran, this study conducted to detect the factors related to acute aortic dissection type A, its surgery consequences and the factors affecting them. Materials and Methods: In this historical cohort study, all patients having acute aortic dissection type A referring to Chamran Hospital from 2006 to 2012 were studied. The impact of two surgical methods including antegrade cerebral perfusion (ACP) and retrograde cerebral one (RCP) on surgical and long-term mortality and recurrence of dissection was determined. The relation of mortality rate and hemodynamic instability before surgery, age more than 70 years old, ejection fraction lower than 50%, prolonged cardiopulmonary bypass pump (CPBP) time and excessive blood transfusion, was assessed. Results: Surgery and long-term mortality and recurrence of dissection were 35.3%, 30.8% and 30.4%. Surgical and long-term death in the patients being operated by ACP method was lower than those one being operated by RCP (P < 0.001). Excessive blood transfusion and unstable hemodynamic condition had significant effect on surgical mortality (P = 0.014, 0.030, respectively). CPBP time and unstable hemodynamic condition affected long-term mortality significantly (P = 0.002). Conclusion: The result found that ACP is the preferable kind of surgery in comparison with RCP according to the surgical and long-term mortality. |
topic |
Acute aortic dissection type A antegrade cerebral perfusion retrograde cerebral perfusion |
url |
http://www.advbiores.net/article.asp?issn=2277-9175;year=2017;volume=6;issue=1;spage=85;epage=85;aulast=Shemirani |
work_keys_str_mv |
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1725390570318200832 |