초록접수 현황
| 16F-116 | 구연 발표 |
Clinical Outcomes of Complicated type A Aortic Dissection
Hyung Tae Sim, Hyoung Woo Chang, Jae Suk Yoo, Kwang Ree Cho, Dong Jin Kim
Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Gyeonggi-do, Korea
Background : The study objective was to assess the results of clinical outcomes of complicated type A aortic dissection
Methods : A review was conducted of 146 patients (M:F = 81 : 65) who were diagnosed as Type A aortic dissection at our institution between January 2005 to July 2016. 41(28.1%, 41/146) patients were defined as complicated type A aortic dissection(CTAD). 34(23.3%, 34/146) patients had mlaperfusion syndrome, 7 patients were at shock state without malperfusion and among them, 3 were intubated with high dose of inotropics and 4 underwent cardiopulmonary resuscitation(CPR) until the initiation of extracorporeal circulation.
Results : 6 patients(malperfusion 4, others 2) were unable to have operation and 4(66.7%, 4/6) expired during the hospital stay. Overall operative mortality was 14.3%(20/140). CTAD had higher operative mortality compared to uncomplicated type A aortic dissection(UTAD) (41.7% (15/36) vs.4.8%(5/104), p<0.05). Operative mortality of malperfusion patients were 40%(12/30). Coronary malperfusion was significant risk factor for operative mortality(p=0.026). 19 of 20 patient’s (95%, 10 patients were unable to have post operative CT) malperfused arterial branch improved after the operation on CT angiographic findings. 4 of 5(including 1 malperfusion patient) patients expired(80%) after the operation who had CPR preoperatively, but one patient had uneventful discharge.
Conclusion : CTAD is a significant risk factor influencing mortality but most of the arterial branch of malperfused segment improved after the operation and one patient had successful operation even under CPR status. The conventional strategy for aggressive operation without delay is still a valid treatment for CTAD.
Methods : A review was conducted of 146 patients (M:F = 81 : 65) who were diagnosed as Type A aortic dissection at our institution between January 2005 to July 2016. 41(28.1%, 41/146) patients were defined as complicated type A aortic dissection(CTAD). 34(23.3%, 34/146) patients had mlaperfusion syndrome, 7 patients were at shock state without malperfusion and among them, 3 were intubated with high dose of inotropics and 4 underwent cardiopulmonary resuscitation(CPR) until the initiation of extracorporeal circulation.
Results : 6 patients(malperfusion 4, others 2) were unable to have operation and 4(66.7%, 4/6) expired during the hospital stay. Overall operative mortality was 14.3%(20/140). CTAD had higher operative mortality compared to uncomplicated type A aortic dissection(UTAD) (41.7% (15/36) vs.4.8%(5/104), p<0.05). Operative mortality of malperfusion patients were 40%(12/30). Coronary malperfusion was significant risk factor for operative mortality(p=0.026). 19 of 20 patient’s (95%, 10 patients were unable to have post operative CT) malperfused arterial branch improved after the operation on CT angiographic findings. 4 of 5(including 1 malperfusion patient) patients expired(80%) after the operation who had CPR preoperatively, but one patient had uneventful discharge.
Conclusion : CTAD is a significant risk factor influencing mortality but most of the arterial branch of malperfused segment improved after the operation and one patient had successful operation even under CPR status. The conventional strategy for aggressive operation without delay is still a valid treatment for CTAD.
책임저자: Dong Jin Kim
Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Gyeonggi-do, Korea
발표자: Dong Jin Kim, E-mail : shallbe@hanmail.net