scholarly journals 475 Acute Type A Aortic Dissection In-Hours Vs Out-Of-Hours: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
S Toh ◽  
D C M Yew ◽  
J J Choong ◽  
T L Chong ◽  
A Harky
Keyword(s):  
Cardiac Surgery ◽  
Aortic Dissection ◽  
Clinical Outcomes ◽  
Meta Analysis ◽  
Type A ◽  
Total Arch Replacement ◽  
Medical Emergency ◽  
Acute Type ◽  
Out Of Hours ◽  
Type A Aortic Dissection

Abstract Introduction Acute type A aortic dissection (ATAAD) is a life-threatening medical emergency requiring immediate surgical intervention. We sought to compare clinical outcomes in patients with ATAAD that undergone surgical repair during in-hours (IH) versus out-of-hours (OOH). Method Electronic database search at PubMed, Ovid, Scopus, Cochrane and Embase was performed from inception till March 2020. Primary outcomes were 30-day mortality, stroke, and re-operation for bleeding; secondary outcomes were previous cardiac surgery and total arch replacement. Results Six articles with a total of 3,744 patients met the inclusion criteria. Re-operation for bleeding and stroke rate were similar, with 18% in IH vs 23% in OOH (RR 0.89, 95% CI [0.73, 1.08], p = 0.24), and 12% in IH vs 13% in OOH (RR 0.83, 95% CI [0.66, 1.03], p = 0.09) respectively. 30-day mortality was significantly lower in IH (26%) vs 24% in OOH (RR 0.81, 95% CI [0.72, 0.90], p = 0.0001). Previous cardiac surgery was higher in IH (5%) vs 4% in OOH patients (p = 0.005). Total arch replacement were similar in both cohorts, 29% in IH vs 32% in OOH (RR 0.96, 95% CI [0.89, 1.04], p = 0.37). Conclusions ATAAD operation during IH and OOH have comparable clinical outcomes. Therefore, operating on such cases should be decided on clinical priority without delay.

Acute type A aortic dissection in‐hours versus out‐of‐hours: A systematic review and meta‐analysis

2020 ◽  
Vol 35 (12) ◽  
pp. 3432-3439 ◽  
Author(s):  
Steven Toh ◽  
Dominic Choon Men Yew ◽  
Jia Jin Choong ◽  
Tze Lin Chong ◽  
Amer Harky
Keyword(s):  
Systematic Review ◽  
Aortic Dissection ◽  
Meta Analysis ◽  
Type A ◽  
Acute Type ◽  
Out Of Hours ◽  
Type A Aortic Dissection

Clinical outcomes of valve-sparing root replacement in acute type A aortic dissection

2015 ◽  
Vol 49 (6) ◽  
pp. 331-336 ◽  
Author(s):  
Heemoon Lee ◽  
Yang Hyun Cho ◽  
Kiick Sung ◽  
Wook Sung Kim ◽  
Kay-Hyun Park ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Clinical Outcomes ◽  
Type A ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Valve Sparing

Surgical outcomes of total arch replacement with modified elephant trunk technique in type A aortic dissection: insights from single-center experience

2022 ◽  
pp. 021849232110701
Author(s):  
Jian Li ◽  
Yueyun Zhou ◽  
Wei Qin ◽  
Cunhua Su ◽  
Fuhua Huang ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Type A ◽  
Total Arch Replacement ◽  
Hospital Death ◽  
Acute Type ◽  
Elephant Trunk ◽  
Type A Aortic Dissection ◽  
Elephant Trunk Technique ◽  
Visceral Malperfusion ◽  
Cerebral Malperfusion

Background Total arch replacement with modified elephant trunk technique plays an important role in treating acute type A aortic dissection in China. We aim to summarize the therapeutic effects of this procedure in our center over a 17-year period. Methods Consecutive patients treated at our hospital due to type A aortic dissection from January 2004 to January 2021 were studied. Relevant data of these patients undergoing total arch replacement with modified elephant trunk technique were collected and analyzed. Results A total of 589 patients were included with a mean age of 53.1 ± 12.2 years. The mean of cardiopulmonary bypass, cross-clamping, and selected cerebral perfusion time were 199.6 ± 41.9, 119.0 ± 27.2, and 25.1 ± 5.0 min, respectively. In-hospital death occurred in 46 patients. Multivariate analysis identified four significant risk factors for in-hospital mortality: preexisting renal hypoperfusion (OR 5.43; 95% CI 1.31 – 22.44; P = 0.020), cerebral malperfusion (OR 11.87; 95% CI 4.13 – 34.12; P < 0.001), visceral malperfusion (OR 4.27; 95% CI 1.01 – 18.14; P = 0.049), and cross-clamp time ≥ 130 min (OR 3.26; 95% CI 1.72 – 6.19; P < 0.001). The 5, 10, and 15 years survival rates were 86.4%, 82.6%, and 70.2%, respectively. Conclusions Total arch replacement with modified elephant trunk technique is an effective treatment for acute type A aortic dissection with satisfactory perioperative results. Patients with preexisting renal hypoperfusion, cerebral malperfusion, visceral malperfusion, and long cross-clamp time are at a higher risk of in-hospital death.

scholarly journals Clinical Outcomes of VasoRing Connector in Patients With Acute Type A Aortic Dissection

2018 ◽  
Vol 106 (3) ◽  
pp. 764-770 ◽  
Author(s):  
I-Ming Chen ◽  
Po-Lin Chen ◽  
Shih-Hsien Weng ◽  
Chiao-Po Hsu ◽  
Chun-Che Shih ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Clinical Outcomes ◽  
Type A ◽  
Acute Type ◽  
Type A Aortic Dissection

scholarly journals A systemic review and meta-analysis: Bentall versus David procedure in acute type A aortic dissection

2018 ◽  
Vol 55 (2) ◽  
pp. 201-209 ◽  
Author(s):  
Selim Mosbahi ◽  
Dushaj Stak ◽  
Isaac Gravestock ◽  
Jakob M Burgstaller ◽  
Johann Steurer ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Meta Analysis ◽  
Type A ◽  
Systemic Review ◽  
Acute Type ◽  
Type A Aortic Dissection
Sign in / Sign up

Export Citation Format

Share Document