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Carotid artery dissection and neurological complications after surgery for type 1 aortic dissection
F. Biancari, T. Mäkikallio, S. Rosato, T. Juvonen, G. Mariscalco, Z. El-Dean, M. Acharya, M. Pettinari, J. Rodriguez-Lega, AG. Pinto, A. Perrotti, F. Onorati, K. Wisniewski, L. Conradi, T. Demal, M. Pol, J. Rocek, P. Kacer, G. Gatti, I....
Language English Country England, Great Britain
Document type Journal Article, Multicenter Study
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- MeSH
- Aortic Aneurysm surgery mortality MeSH
- Carotid Artery, Common surgery diagnostic imaging MeSH
- Aortic Dissection * surgery diagnosis mortality MeSH
- Risk Assessment methods MeSH
- Middle Aged MeSH
- Humans MeSH
- Hospital Mortality * trends MeSH
- Follow-Up Studies MeSH
- Postoperative Complications * epidemiology MeSH
- Registries * MeSH
- Retrospective Studies MeSH
- Risk Factors MeSH
- Aged MeSH
- Vascular Surgical Procedures adverse effects methods MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Geographicals
- Europe MeSH
BACKGROUND: Data on the prognostic impact of type A aortic dissection involving the common carotid arteries (CCAs) are scarce. METHODS: Data on the status of the CCAs were available in 1106 patients who underwent surgery for acute DeBakey type 1 aortic dissection who were recruited in a retrospective, multicentre European registry, that is, the ERTAAD. Postoperative neurological complications were defined as ischaemic stroke, haemorrhagic stroke and/or global brain ischaemia. RESULTS: Patients without carotid artery dissection, those with unilateral or bilateral CCA dissection had in-hospital mortality rates of 19.5%, 16.9% (OR 1.006, 95% CI 0.614 to 1.647) and 27.3% (p<0.001, OR 1.719, 95% CI 1.086 to 2.722), respectively. Bilateral, but not unilateral, dissection of the CCAs increased the risk of neurological complications (40.0% vs 18.9%, OR 2.453, 95% CI 1.683 to 3.576). The negative prognostic effect of bilateral dissection of the CCAs was increased among patients without cerebral malperfusion who underwent surgery with the use of hypothermic circulatory arrest (28.7% vs 4.3%, p=0.014). CONCLUSIONS: Bilateral, but not unilateral, dissection of the CCAs may increase the risk of neurological complications and in-hospital mortality after surgery for DeBakey type 1 aortic dissection. TRIAL REGISTRATION NUMBER: NCT04831073.
Cardiac Surgery Molinette Hospital University of Turin Torino Italy
Cardiovascular Surgery Department Hospital General Universitario Gregorio Maranon Madrid Spain
Department of Biomedical Surgical and Dental Sciences University of Milan Milan Italy
Department of Cardiac Surgery Centre Hospitalier Annecy Genevois Epagny Metz Tessy France
Department of Cardiac Surgery Glenfield Hospital Leicester UK
Department of Cardiac Surgery Ludwig Maximilian University of Munich Munchen Germany
Department of Cardiac Surgery Martin Luther University Halle Wittenberg Halle Germany
Department of Cardiac Surgery Ziekenhuis Oost Limburg Genk Belgium
Department of Cardiothoracic Surgery University Hospital Munster Muenster Germany
Department of Cardiovascular Surgery University of Hamburg Hamburg Germany
Division of Cardiac Surgery University of Verona Verona Italy
German Centre for Cardiovascular Research Partner Site Munich Heart Alliance Munich Germany
Helsinki University Hospital Heart and Lung Center Helsinki Finland
National Center for Global Health Istituto Superiore di Sanità Roma Italy
References provided by Crossref.org
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- $a Biancari, Fausto $u Department of Cardiovascular Surgery, Centro Cardiologico Monzino Istituto di Ricovero e Cura a Carattere Scientifico, Milano, Italy faustobiancari@yahoo.it $1 https://orcid.org/0000000150288186
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- $a Carotid artery dissection and neurological complications after surgery for type 1 aortic dissection / $c F. Biancari, T. Mäkikallio, S. Rosato, T. Juvonen, G. Mariscalco, Z. El-Dean, M. Acharya, M. Pettinari, J. Rodriguez-Lega, AG. Pinto, A. Perrotti, F. Onorati, K. Wisniewski, L. Conradi, T. Demal, M. Pol, J. Rocek, P. Kacer, G. Gatti, I. Vendramin, D. Piani, M. Rinaldi, L. Ferrante, E. Quintana, R. Pruna-Guillen, S. Peterss, J. Buech, C. Radner, M. Field, A. Harky, A. Fiore, J. Sénémaud, C. Mustonen, AM. Dell'Aquila, P. D'Errigo, G. Polvani, D. Di Perna
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- $a BACKGROUND: Data on the prognostic impact of type A aortic dissection involving the common carotid arteries (CCAs) are scarce. METHODS: Data on the status of the CCAs were available in 1106 patients who underwent surgery for acute DeBakey type 1 aortic dissection who were recruited in a retrospective, multicentre European registry, that is, the ERTAAD. Postoperative neurological complications were defined as ischaemic stroke, haemorrhagic stroke and/or global brain ischaemia. RESULTS: Patients without carotid artery dissection, those with unilateral or bilateral CCA dissection had in-hospital mortality rates of 19.5%, 16.9% (OR 1.006, 95% CI 0.614 to 1.647) and 27.3% (p<0.001, OR 1.719, 95% CI 1.086 to 2.722), respectively. Bilateral, but not unilateral, dissection of the CCAs increased the risk of neurological complications (40.0% vs 18.9%, OR 2.453, 95% CI 1.683 to 3.576). The negative prognostic effect of bilateral dissection of the CCAs was increased among patients without cerebral malperfusion who underwent surgery with the use of hypothermic circulatory arrest (28.7% vs 4.3%, p=0.014). CONCLUSIONS: Bilateral, but not unilateral, dissection of the CCAs may increase the risk of neurological complications and in-hospital mortality after surgery for DeBakey type 1 aortic dissection. TRIAL REGISTRATION NUMBER: NCT04831073.
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