초록접수 현황

17F-118 구연 발표

Preoperative Hemodynamic Status and Outcomes of Surgery for Acute Type A Aortic Dissection
Jong Bum Choi, Jong Hun Kim, Tae Youn Kim, Joon Young Song, Ja Hong Kuh
Department of Thoracic and Cardiovascular Surgery, Chonbuk National University Hospital, Chonbuk National University College of Medicine, Jeollabuk-do, Republic of Korea

Purpose : Acute type A aortic dissection is a cardiovascular disease that requires emergency surgical repair and has high postoperative mortality. To investigate predictive factors affecting hospital deaths, we retrospectively analyzed our surgical outcomes.

Methods : Between September 2007 and December 2016, there were 99 patients who had emergency surgery for acute type A aortic dissection, including replacement of the hemi-arch in 62 patients (63%), total arch in 32 patients (32%), and ascending aorta in 5 patients (5%). Aortic root reimplant or replacement was performed in 7 patients (7%) and sinus replacement or reinforcement in 14 patients (14%). Intimal tear was observed in 89 patients (90%).

Results : Hospital death occurred in 8 of 99 patients (8%), including 2 of 47 patients (4%) during the past 3year. In univariate analyses, predictive factors for hospital death were shock, iliac artery involvement, retrograde cerebral perfusion, entire root dissection, and preoperative poor perfusion. Logical regression showed that preoperative shock was an independent predictor of hospital death (relative risk, 9.3; 95% confidence interval, 1.6-53.6, P = .01). Bypass and circulatory arrest times were significantly longer in patients with aortic root surgery or total arch replacement than in patients with hemiarch replacement, but did not affect early surgical outcomes. The 1-year survival was 95 ± 2% and 5-year survival 92 ± 3%.

Conclusion : Preoperative shock is the only predictor of hospital death. Although there were no statistical differences in surgical outcomes between earlier and later study years, improved surgical strategies have reduced hospital mortality.


책임저자: Jong Bum Choi
Department of Thoracic and Cardiovascular Surgery, Chonbuk National University Hospital, Chonbuk National University College of Medicine, Jeollabuk-do, Republic of Korea
발표자: Tae Yun Kim, E-mail : uadocjon1314@hanmail.net

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