Brachiocephalic artery dissection is a marker of stroke after acute type A aortic dissection repair.
aorta and great vessels
cardiovascular research
Journal
Journal of cardiac surgery
ISSN: 1540-8191
Titre abrégé: J Card Surg
Pays: United States
ID NLM: 8908809
Informations de publication
Date de publication:
Mar 2021
Mar 2021
Historique:
received:
29
10
2020
revised:
16
12
2020
accepted:
18
12
2020
pubmed:
15
1
2021
medline:
15
5
2021
entrez:
14
1
2021
Statut:
ppublish
Résumé
Postoperative stroke is a serious unsolved complication after acute type A aortic dissection (ATAAD) repair. We investigated the incidence and risk factors of stroke, and hypothesized that dissection of supra-aortic vessels is an important risk factor of this morbidity. Between 2012 and 2019, 202 (56% men, median age 68 years) patients with ATAAD underwent surgical repair. Clinical data, image findings, method of circulatory support, and repair technique were retrospectively investigated to explore the risk factor of postoperative stroke. Of the 202 patients, operative mortality was 6% and the incidence of postoperative stroke was 12% (n = 25). Brachiocephalic artery (BCA) dissection was associated with a higher risk of stroke (odds ratio, 3.89; 95% confidence interval, 1.104-13.780; p = .035) having no relation to the presence or absence of left common carotid artery dissection. Preoperative malperfusion syndrome, circulatory arrest time, isolated cerebral perfusion time, repair technique (total arch replacement), and femoral artery perfusion alone were not related to the incident rate of postoperative stroke. Stroke occurred in both hemispheres, regardless of the laterality of carotid artery dissection. BCA dissection was an independent risk factor of stroke after ATAAD repair.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
902-908Informations de copyright
© 2021 Wiley Periodicals LLC.
Références
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