Impact of supra-aortic vessel dissection on the neurological outcome in surgery for acute type A aortic dissection

被引:0
|
作者
Koji Yamana
Yoshiyuki Takami
Yoshinori Nakahara
Takeyuki Kanemura
Atsuo Maekawa
Yasushi Takagi
机构
[1] Fujita Health University School of Medicine,Department of Cardiovascular Surgery
[2] IMS Katsushika Heart Center,Department of Cardiovascular Surgery
来源
Heart and Vessels | 2022年 / 37卷
关键词
Type A acute aortic dissection; Neurological dysfunction; Supra-aortic vessel dissection; Dissection-related stenosis in supra-aortic vessels;
D O I
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学科分类号
摘要
We investigated whether supra-aortic vessel (SAV)s dissection is a risk factor for neurological dysfunction (ND) after surgical repair for type A acute aortic dissection (TAAAD). A retrospective review was done in 178 patients with TAAAD undergoing aortic repair between 2015 and 2019, comparing those with SAV dissection to those without it. Preoperatively, 93 patients (54.4%) had SAV dissection. Postoperatively, ND occurred in 26 patients (14.6%), 17 of whom (65.4%) already had been present with preoperative ND. Patients with SAV dissection were more likely to have postoperative ND than those without it (21.5% vs 7.7%; p = 0.02). The severity of preoperative dissection-related stenosis in common carotid artery significantly related to postoperative ND (right; p =0.0071, left; p < 0.0001). Multivariable analysis showed dissection-related stenosis of > 75% in brachiocepharic and left common carotid arteries, and thrombosed false lumen in common carotid arteries were independent risk factors for postoperative ND. However, SAV dissection was not related to new onset of ND. Dissection with stenosis of > 75% in SAVs were significantly decreased after aortic repair and even after ascending aorta/hemiarch replacement. In conclusion, ND after surgical repair for TAAAD is closely related to SAV dissection, especially to stenosis of > 75% and thrombosed false lumen in common carotid arteries. Aortic repair significantly decreased SAV dissection and severity of stenosis.
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页码:1628 / 1635
页数:7
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