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Direct Aortic Versus Supra-Aortic Arterial Cannulation During Surgery for Acute Type A Aortic Dissection
T. Juvonen, M. Jormalainen, C. Mustonen, T. Demal, A. Fiore, A. Perrotti, A. Hervé, E. Mazzaro, G. Gatti, M. Pettinari, S. Peterss, J. Buech, F. Nappi, L. Conradi, AG. Pinto, J. Rodriguez Lega, M. Pol, P. Kacer, AM. Dell'Aquila, A. Rukosujew, K....
Jazyk angličtina Země Spojené státy americké
Typ dokumentu multicentrická studie, časopisecké články, práce podpořená grantem
NLK
ProQuest Central
od 1997-01-01 do 2023-12-31
Medline Complete (EBSCOhost)
od 2003-04-01 do Před 1 rokem
Health & Medicine (ProQuest)
od 1997-01-01 do 2023-12-31
- MeSH
- aorta MeSH
- disekce aorty * chirurgie MeSH
- katetrizace * MeSH
- kohortové studie MeSH
- lidé MeSH
- retrospektivní studie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
AIMS: In this study we evaluated the impact of direct aortic cannulation versus innominate/subclavian/axillary artery cannulation on the outcome after surgery for type A aortic dissection. METHODS: The outcomes of patients included in a multicenter European registry (ERTAAD) who underwent surgery for acute type A aortic dissection with direct aortic cannulation versus those with innominate/subclavian/axillary artery cannulation, i.e. supra-aortic arterial cannulation, were compared using propensity score matched analysis. RESULTS: Out of 3902 consecutive patients included in the registry, 2478 (63.5%) patients were eligible for this analysis. Direct aortic cannulation was performed in 627 (25.3%) patients, while supra-aortic arterial cannulation in 1851 (74.7%) patients. Propensity score matching yielded 614 pairs of patients. Among them, patients who underwent surgery for TAAD with direct aortic cannulation had significantly decreased in-hospital mortality (12.7% vs. 18.1%, p = 0.009) compared to those who had supra-aortic arterial cannulation. Furthermore, direct aortic cannulation was associated with decreased postoperative rates of paraparesis/paraplegia (2.0 vs. 6.0%, p < 0.0001), mesenteric ischemia (1.8 vs. 5.1%, p = 0.002), sepsis (7.0 vs. 14.2%, p < 0.0001), heart failure (11.2 vs. 15.2%, p = 0.043), and major lower limb amputation (0 vs. 1.0%, p = 0.031). Direct aortic cannulation showed a trend toward decreased risk of postoperative dialysis (10.1 vs. 13.7%, p = 0.051). CONCLUSIONS: This multicenter cohort study showed that direct aortic cannulation compared to supra-aortic arterial cannulation is associated with a significant reduction of the risk of in-hospital mortality after surgery for acute type A aortic dissection. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04831073.
Anesthesia and Critical Care Research Unit of Surgery University of Oulu Oulu Finland
Cardiac Surgery Molinette Hospital University of Turin Turin Italy
Cardiothoracic Department University Hospital Udine Italy
Cardiovascular Surgery Department University Hospital Gregorio Marañón Madrid Spain
Centre Hospitalier Annecy Genevois Epagny Metz Tessy France
Department of Cardiac Surgery Centre Cardiologique du Nord de Saint Denis Paris France
Department of Cardiac Surgery Glenfield Hospital Leicester UK
Department of Cardiac Surgery Ziekenhuis Oost Limburg Genk Belgium
Department of Cardiothoracic Surgery University Hospital Muenster Muenster Germany
Department of Cardiovascular Surgery University Heart and Vascular Center Hamburg Hamburg Germany
Department of Medicine South Karelia Central Hospital University of Helsinki Lappeenranta Finland
Department of Thoracic and Cardiovascular Surgery University of Franche Comte Besancon France
Division of Cardiac Surgery University of Verona Medical School Verona Italy
German Centre for Cardiovascular Research Partner Site Munich Heart Alliance Munich Germany
Heart and Lung Center Helsinki University Hospital University of Helsinki 00029 Helsinki Finland
Liverpool Centre for Cardiovascular Sciences Liverpool Heart and Chest Hospital Liverpool UK
LMU University Hospital Ludwig Maximilian University Munich Germany
Citace poskytuje Crossref.org
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