Protective Effect on Spinal Cord Injury of Prophylactic Cerebrospinal Fluid Drainage in Extensive Aortic Arch Repair for Type A Aortic Dissection: A Retrospective Cohort Study
被引:0
|
作者:
Zhou, Chenyu
论文数: 0引用数: 0
h-index: 0
机构:
Chinese Acad Med Sci & Peking Union Med Coll, Natl Ctr Cardiovasc Dis, Natl Clin Res Ctr Cardiovasc Dis, Dept Aort Surg,Fuwai Hosp, 167 North Lishi Rd, Beijing 100037, Peoples R ChinaChinese Acad Med Sci & Peking Union Med Coll, Natl Ctr Cardiovasc Dis, Natl Clin Res Ctr Cardiovasc Dis, Dept Aort Surg,Fuwai Hosp, 167 North Lishi Rd, Beijing 100037, Peoples R China
Zhou, Chenyu
[1
]
Hou, Bin
论文数: 0引用数: 0
h-index: 0
机构:
Chinese Acad Med Sci & Peking Union Med Coll, Natl Ctr Cardiovasc Dis, Natl Clin Res Ctr Cardiovasc Dis, Dept Aort Surg,Fuwai Hosp, 167 North Lishi Rd, Beijing 100037, Peoples R ChinaChinese Acad Med Sci & Peking Union Med Coll, Natl Ctr Cardiovasc Dis, Natl Clin Res Ctr Cardiovasc Dis, Dept Aort Surg,Fuwai Hosp, 167 North Lishi Rd, Beijing 100037, Peoples R China
Hou, Bin
[1
]
Zhang, Kai
论文数: 0引用数: 0
h-index: 0
机构:
Chinese Acad Med Sci & Peking Union Med Coll, Natl Ctr Cardiovasc Dis, Natl Clin Res Ctr Cardiovasc Dis, Dept Aort Surg,Fuwai Hosp, 167 North Lishi Rd, Beijing 100037, Peoples R ChinaChinese Acad Med Sci & Peking Union Med Coll, Natl Ctr Cardiovasc Dis, Natl Clin Res Ctr Cardiovasc Dis, Dept Aort Surg,Fuwai Hosp, 167 North Lishi Rd, Beijing 100037, Peoples R China
Zhang, Kai
[1
]
Gao, Shiqi
论文数: 0引用数: 0
h-index: 0
机构:
Chinese Acad Med Sci & Peking Union Med Coll, Natl Ctr Cardiovasc Dis, Natl Clin Res Ctr Cardiovasc Dis, Dept Aort Surg,Fuwai Hosp, 167 North Lishi Rd, Beijing 100037, Peoples R ChinaChinese Acad Med Sci & Peking Union Med Coll, Natl Ctr Cardiovasc Dis, Natl Clin Res Ctr Cardiovasc Dis, Dept Aort Surg,Fuwai Hosp, 167 North Lishi Rd, Beijing 100037, Peoples R China
Gao, Shiqi
[1
]
Cao, Fangfang
论文数: 0引用数: 0
h-index: 0
机构:
Chinese Acad Med Sci & Peking Union Med Coll, Natl Ctr Cardiovasc Dis, Natl Clin Res Ctr Cardiovasc Dis, Adult Surg Intens Care Unit,Fuwai Hosp, Beijing, Peoples R ChinaChinese Acad Med Sci & Peking Union Med Coll, Natl Ctr Cardiovasc Dis, Natl Clin Res Ctr Cardiovasc Dis, Dept Aort Surg,Fuwai Hosp, 167 North Lishi Rd, Beijing 100037, Peoples R China
Cao, Fangfang
[2
]
Ji, Yumeng
论文数: 0引用数: 0
h-index: 0
机构:
Chinese Acad Med Sci & Peking Union Med Coll, Natl Ctr Cardiovasc Dis, Natl Clin Res Ctr Cardiovasc Dis, Dept Aort Surg,Fuwai Hosp, 167 North Lishi Rd, Beijing 100037, Peoples R ChinaChinese Acad Med Sci & Peking Union Med Coll, Natl Ctr Cardiovasc Dis, Natl Clin Res Ctr Cardiovasc Dis, Dept Aort Surg,Fuwai Hosp, 167 North Lishi Rd, Beijing 100037, Peoples R China
Ji, Yumeng
[1
]
Xie, Enzehua
论文数: 0引用数: 0
h-index: 0
机构:
Chinese Acad Med Sci & Peking Union Med Coll, Natl Ctr Cardiovasc Dis, Natl Clin Res Ctr Cardiovasc Dis, Dept Aort Surg,Fuwai Hosp, 167 North Lishi Rd, Beijing 100037, Peoples R ChinaChinese Acad Med Sci & Peking Union Med Coll, Natl Ctr Cardiovasc Dis, Natl Clin Res Ctr Cardiovasc Dis, Dept Aort Surg,Fuwai Hosp, 167 North Lishi Rd, Beijing 100037, Peoples R China
Xie, Enzehua
[1
]
Qiu, Jiawei
论文数: 0引用数: 0
h-index: 0
机构:
Chinese Acad Med Sci & Peking Union Med Coll, Natl Ctr Cardiovasc Dis, Natl Clin Res Ctr Cardiovasc Dis, Dept Aort Surg,Fuwai Hosp, 167 North Lishi Rd, Beijing 100037, Peoples R ChinaChinese Acad Med Sci & Peking Union Med Coll, Natl Ctr Cardiovasc Dis, Natl Clin Res Ctr Cardiovasc Dis, Dept Aort Surg,Fuwai Hosp, 167 North Lishi Rd, Beijing 100037, Peoples R China
Qiu, Jiawei
[1
]
Qiu, Juntao
论文数: 0引用数: 0
h-index: 0
机构:
Chinese Acad Med Sci & Peking Union Med Coll, Natl Ctr Cardiovasc Dis, Natl Clin Res Ctr Cardiovasc Dis, Dept Aort Surg,Fuwai Hosp, 167 North Lishi Rd, Beijing 100037, Peoples R ChinaChinese Acad Med Sci & Peking Union Med Coll, Natl Ctr Cardiovasc Dis, Natl Clin Res Ctr Cardiovasc Dis, Dept Aort Surg,Fuwai Hosp, 167 North Lishi Rd, Beijing 100037, Peoples R China
Qiu, Juntao
[1
]
Yu, Cuntao
论文数: 0引用数: 0
h-index: 0
机构:
Chinese Acad Med Sci & Peking Union Med Coll, Natl Ctr Cardiovasc Dis, Natl Clin Res Ctr Cardiovasc Dis, Dept Aort Surg,Fuwai Hosp, 167 North Lishi Rd, Beijing 100037, Peoples R ChinaChinese Acad Med Sci & Peking Union Med Coll, Natl Ctr Cardiovasc Dis, Natl Clin Res Ctr Cardiovasc Dis, Dept Aort Surg,Fuwai Hosp, 167 North Lishi Rd, Beijing 100037, Peoples R China
Yu, Cuntao
[1
]
机构:
[1] Chinese Acad Med Sci & Peking Union Med Coll, Natl Ctr Cardiovasc Dis, Natl Clin Res Ctr Cardiovasc Dis, Dept Aort Surg,Fuwai Hosp, 167 North Lishi Rd, Beijing 100037, Peoples R China
[2] Chinese Acad Med Sci & Peking Union Med Coll, Natl Ctr Cardiovasc Dis, Natl Clin Res Ctr Cardiovasc Dis, Adult Surg Intens Care Unit,Fuwai Hosp, Beijing, Peoples R China
来源:
JOURNAL OF THE AMERICAN HEART ASSOCIATION
|
2025年
/
14卷
/
05期
关键词:
cerebrospinal fluid drainage;
frozen elephant trunk;
spinal cord injury;
total arch replacement;
type A aortic dissection;
INTERNATIONAL REGISTRY;
PERFUSION-PRESSURE;
REPLACEMENT;
RISK;
D O I:
10.1161/JAHA.124.039427
中图分类号:
R5 [内科学];
学科分类号:
1002 ;
100201 ;
摘要:
Background Cerebrospinal fluid drainage (CSFD) is commonly used to manage spinal cord injury (SCI) after aortic surgery. However, there is still limited evidence regarding its effectiveness in patients with type A aortic dissection undergoing total arch replacement plus frozen elephant trunk procedure. Methods A total of 1931 patients were retrospectively enrolled between 2010 and 2023. Patients with high-risk postoperative SCI (N=445) were divided into 2 groups: with or without prophylactic CSFD to evaluate the protective effect of prophylactic CSFD. Patients with postoperative SCI (N=119) were divided into 3 groups, without CSFD, therapeutic CSFD, and prophylactic CSFD, and analyzed to compare the treatment effect of different CSFD strategies. Results Prophylactic CSFD significantly reduced the incidence of postoperative SCI in high-risk patients (26.9% versus 17.7%, P=0.029), further supported by matching weights analysis of propensity score and conditional logistic regression. Analyses of the SCI population revealed less severe SCI symptoms in patients with prophylactic CSFD, as assessed by the American Spinal Injury Association Impairment Scale (adjusted P<0.05). Multivariable ordinal logistic regression showed that compared with those without CSFD, prophylactic CSFD (P=0.003) but not therapeutic CSFD (P=0.981) was beneficial to the in-hospital recovery of postoperative SCI. Long-term SCI outcomes did not differ among groups. Conclusions A prominent protective effect on SCI occurrence and recovery after the total arch replacement plus the frozen elephant trunk procedure was observed with prophylactic CSFD use in patients with type A aortic dissection. However, the effectiveness of therapeutic CSFD fell short of significance.
机构:
Chinese Acad Med Sci & Peking Union Med Coll, Fuwai Hosp, Natl Ctr Cardiovasc Dis, Cardiovasc Surg Dept, South Nanli Rd 167, Beijing 100037, Peoples R ChinaChinese Acad Med Sci & Peking Union Med Coll, Fuwai Hosp, Natl Ctr Cardiovasc Dis, Cardiovasc Surg Dept, South Nanli Rd 167, Beijing 100037, Peoples R China
Wei, Jinhua
Hu, Zhan
论文数: 0引用数: 0
h-index: 0
机构:
Chinese Acad Med Sci & Peking Union Med Coll, Fuwai Hosp, Natl Ctr Cardiovasc Dis, Cardiovasc Surg Dept, South Nanli Rd 167, Beijing 100037, Peoples R ChinaChinese Acad Med Sci & Peking Union Med Coll, Fuwai Hosp, Natl Ctr Cardiovasc Dis, Cardiovasc Surg Dept, South Nanli Rd 167, Beijing 100037, Peoples R China
Hu, Zhan
Wang, Wei
论文数: 0引用数: 0
h-index: 0
机构:
Chinese Acad Med Sci & Peking Union Med Coll, Fuwai Hosp, Natl Ctr Cardiovasc Dis, Cardiovasc Surg Dept, South Nanli Rd 167, Beijing 100037, Peoples R ChinaChinese Acad Med Sci & Peking Union Med Coll, Fuwai Hosp, Natl Ctr Cardiovasc Dis, Cardiovasc Surg Dept, South Nanli Rd 167, Beijing 100037, Peoples R China
Wang, Wei
Ding, Runyu
论文数: 0引用数: 0
h-index: 0
机构:
Chinese Acad Med Sci & Peking Union Med Coll, Fuwai Hosp, Natl Ctr Cardiovasc Dis, Cardiovasc Surg Dept, South Nanli Rd 167, Beijing 100037, Peoples R ChinaChinese Acad Med Sci & Peking Union Med Coll, Fuwai Hosp, Natl Ctr Cardiovasc Dis, Cardiovasc Surg Dept, South Nanli Rd 167, Beijing 100037, Peoples R China
Ding, Runyu
Xu, Fei
论文数: 0引用数: 0
h-index: 0
机构:
Chinese Acad Med Sci & Peking Union Med Coll, Fuwai Hosp, Natl Ctr Cardiovasc Dis, Cardiovasc Surg Dept, South Nanli Rd 167, Beijing 100037, Peoples R ChinaChinese Acad Med Sci & Peking Union Med Coll, Fuwai Hosp, Natl Ctr Cardiovasc Dis, Cardiovasc Surg Dept, South Nanli Rd 167, Beijing 100037, Peoples R China
机构:
Univ N Carolina, Chapel Hill Sch Med, Dept Anesthesiol, Div Liver Transplant Anesthesiol, Chapel Hill, NC 27599 USAUniv N Carolina, Chapel Hill Sch Med, Dept Anesthesiol, Div Liver Transplant Anesthesiol, Chapel Hill, NC 27599 USA
Isaak, Robert S.
Furman, William
论文数: 0引用数: 0
h-index: 0
机构:
Vanderbilt Univ, Sch Med, Dept Anesthesiol, Div Multispecialty Adult Anesthesiol, Nashville, TN 37212 USAUniv N Carolina, Chapel Hill Sch Med, Dept Anesthesiol, Div Liver Transplant Anesthesiol, Chapel Hill, NC 27599 USA
机构:
Nagoya Univ, Dept Cardiac Surg, Grad Sch Med, Syowa Ku, Nagoya, Aichi 4668550, JapanNagoya Univ, Dept Cardiac Surg, Grad Sch Med, Syowa Ku, Nagoya, Aichi 4668550, Japan
Mutsuga, Masato
Narita, Yuji
论文数: 0引用数: 0
h-index: 0
机构:
Nagoya Univ, Dept Cardiac Surg, Grad Sch Med, Syowa Ku, Nagoya, Aichi 4668550, JapanNagoya Univ, Dept Cardiac Surg, Grad Sch Med, Syowa Ku, Nagoya, Aichi 4668550, Japan
Narita, Yuji
Araki, Yoshimori
论文数: 0引用数: 0
h-index: 0
机构:
Nagoya Univ, Dept Cardiac Surg, Grad Sch Med, Syowa Ku, Nagoya, Aichi 4668550, JapanNagoya Univ, Dept Cardiac Surg, Grad Sch Med, Syowa Ku, Nagoya, Aichi 4668550, Japan
Araki, Yoshimori
Maekawa, Atsuo
论文数: 0引用数: 0
h-index: 0
机构:
Nagoya Univ, Dept Cardiac Surg, Grad Sch Med, Syowa Ku, Nagoya, Aichi 4668550, JapanNagoya Univ, Dept Cardiac Surg, Grad Sch Med, Syowa Ku, Nagoya, Aichi 4668550, Japan
Maekawa, Atsuo
Oshima, Hideki
论文数: 0引用数: 0
h-index: 0
机构:
Nagoya Univ, Dept Cardiac Surg, Grad Sch Med, Syowa Ku, Nagoya, Aichi 4668550, JapanNagoya Univ, Dept Cardiac Surg, Grad Sch Med, Syowa Ku, Nagoya, Aichi 4668550, Japan
Oshima, Hideki
Usui, Akihiko
论文数: 0引用数: 0
h-index: 0
机构:
Nagoya Univ, Dept Cardiac Surg, Grad Sch Med, Syowa Ku, Nagoya, Aichi 4668550, JapanNagoya Univ, Dept Cardiac Surg, Grad Sch Med, Syowa Ku, Nagoya, Aichi 4668550, Japan
Usui, Akihiko
Ueda, Yuichi
论文数: 0引用数: 0
h-index: 0
机构:
Nagoya Univ, Dept Cardiac Surg, Grad Sch Med, Syowa Ku, Nagoya, Aichi 4668550, JapanNagoya Univ, Dept Cardiac Surg, Grad Sch Med, Syowa Ku, Nagoya, Aichi 4668550, Japan
机构:
All India Inst Med Sci, Dept Cardiovasc Radiol & Endovasc Intervent, New Delhi 110029, IndiaAll India Inst Med Sci, Dept Cardiovasc Radiol & Endovasc Intervent, New Delhi 110029, India
Verma, Mansi
Ojha, Vineeta
论文数: 0引用数: 0
h-index: 0
机构:
All India Inst Med Sci, Dept Cardiovasc Radiol & Endovasc Intervent, New Delhi 110029, IndiaAll India Inst Med Sci, Dept Cardiovasc Radiol & Endovasc Intervent, New Delhi 110029, India
Ojha, Vineeta
Deshpande, Amit Ajit
论文数: 0引用数: 0
h-index: 0
机构:
All India Inst Med Sci, Dept Cardiovasc Radiol & Endovasc Intervent, New Delhi 110029, IndiaAll India Inst Med Sci, Dept Cardiovasc Radiol & Endovasc Intervent, New Delhi 110029, India
Deshpande, Amit Ajit
Pratap Singh, Surya
论文数: 0引用数: 0
h-index: 0
机构:
All India Inst Med Sci, Dept Cardiovasc Radiol & Endovasc Intervent, New Delhi 110029, IndiaAll India Inst Med Sci, Dept Cardiovasc Radiol & Endovasc Intervent, New Delhi 110029, India
Pratap Singh, Surya
Ramakrishnan, Pradeep
论文数: 0引用数: 0
h-index: 0
机构:
All India Inst Med Sci, Dept Cardiovasc Thorac Surg, New Delhi, IndiaAll India Inst Med Sci, Dept Cardiovasc Radiol & Endovasc Intervent, New Delhi 110029, India
Ramakrishnan, Pradeep
Kumar, Sanjeev
论文数: 0引用数: 0
h-index: 0
机构:
All India Inst Med Sci, Dept Cardiovasc Radiol & Endovasc Intervent, New Delhi 110029, IndiaAll India Inst Med Sci, Dept Cardiovasc Radiol & Endovasc Intervent, New Delhi 110029, India