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2021, vol. 149, br. 11-12, str. 678-684
Faktori koji utiču na rane hirurške ishode bolesnika sa akutnom disekcijom aorte tipa A
aUniverzitet u Beogradu, Medicinski fakultet, Institut za kardiovaskularne bolesti 'Dedinje'
bUniverzitet u Beogradu, Medicinski fakultet, Institut za kardiovaskularne bolesti 'Dedinje' + Univerzitet u Beogradu, Medicinski fakultet
cUniverzitet u Beogradu, Medicinski fakultet + Klinički centar Srbije, Klinika za ginekologiju i akušerstvo, Beograd
dUniverzitet u Beogradu, Medicinski fakultet, KBC 'Dr Dragiša Mišović'

e-adresadr.inesic@gmail.com
Ključne reči: akutna disekcija aorte tipa A; operacija; ishod; faktori rizika
Sažetak
Uvod/Cilj Čak i uz trenutno lečenje, smrtnost od disekcije aorte ostaje visoka. Cilj studije bio je da se evaluira rani postoperativni ishod bolesnika sa akutnom disekcijom aorte tipa A i identifikuje faktore koji mogu uticati na njega. Metode Studija je obuhvatila sve uzastopne bolesnike operisane zbog akutne disekcije aorte tipa A od 2012. do 2017. godine. Registrovali smo sve parametre koji mogu uticati na ishod (opšti podaci, istorija bolesti, nalazi kliničkih i kardioloških dijagnostičkih testova, preoperativne komplikacije, tip kanulacije i izvedene operacije, dodatnih hirurških postupaka, trajanje operacije itd.). Bolesnici su hirurški lečeni prema važećim protokolima. Glavne mere ishoda bile su komplikacije i mortalitet tokom jednog meseca postoperativnog perioda. Svi podaci prikupljeni preoperativno, intraoperativno i postoperativno upoređeni su i statistički analizirani. Rezultati Studija je obuhvatila 246 bolesnika, prosečne starosti 57,54 ± 12,88 godina i uglavnom muškog pola (74%). Rani postoperativni mortalitet dogodio se kod 17% bolesnika. Preoperativna hronična insuficijencija bubrega (p = 0,005) i cerebrovaskularni insult (p = 0,047) i tamponada (p = 0,036) bili su glavni faktori rizika za postoperativne komplikacije i mortalitet. Dugo trajanje hipotermičnog srčanog zastoja (p = 0,001), totalne kleme (p = 0,017) i kardiopulmonalnog bajpasa (p = 0,036) povećavali su postoperativne komplikacije. Postoperativne komplikacije počele su da se javljaju nakon ≥ 33,5 minuta hipotermičnog srčanog zastoja i ≥ 67,5 minuta vremena totalne kleme. Postojanje više postoperativnih komplikacija (p = 0,034) povećavalo je, dok je izvođenje anterogradne cerebralne perfuzije smanjivalo učestalost smrtnog ishoda (p = 0,001). Zaključak Većina bolesnika hirurški lečenih zbog akutne disekcije aorte tipa A imala je dobar postoperativni ishod. Međutim, brojni preoperativni, intraoperativni i postoperativni faktori mogu uticati na preživljavanje bolesnika.
Reference
Akiyoshi, K., Kimura, N., Aizawa, K., Hori, D., Okamura, H., Morita, H., et al. (2019) Surgical outcomes of acute type A aortic dissection in dialysis patients. General Thoracic and Cardiovascular Surgery, 67(6): 501-509
Bekkers, J.A., Raap, G.B., Takkenberg, J.J., Bogers, A.J. (2013) Acute type A aortic dissection: long-term results and reoperations. European Journal of Cardio-Thoracic Surgery, 43(2): 389-396
Berdajs, D., Mosbahi, S., Ferrari, E., Charbonnier, D., von Segesser, L.K. (2017) Aortic Valve Pathology as a Predictive Factor for Acute Aortic Dissection. Annals of Thoracic Surgery, 104(4): 1340-1348
Chiappini, B., Schepens, M., Tan, E., Amore, D.A., Morshuis, W., Dossche, K., et al. (2014) Early and late outcomes of acute type A aortic dissection: analysis of risk factors in 487 consecutive patients. Euro Heart J, 26(2): 180-186
Czerny, M., Schmidli, J., Adler, S., van den Berg, J.C., Bertoglio, L., Carrel, T., et al. (2019) Current options and recommendations for the treatment of thoracic aortic pathologies involving the aortic arch: an expert consensus document of the European Association for CardioThoracic surgery (EACTS) and the European Society for Vascular Surgery. Eur J Cardiothorac Surg, 55(1): 133-62
Djukanovic, B.P., Micovic, S., Peric, M.S., Milojevic, P.S., Cirkovic, M.V., Boricic, M., et al. (2015) The role of transapical cannulation in the operative management of acute aortic dissection. Perfusion, 30(4): 332-336
Etz, C.D., von Aspern, K., da Rocha, S.E.J., Girrbach, F.F., Leontyev, S., Luehr, M., et al. (2014) Impact of perfusion strategy on outcome after repair for acute type a aortic dissection. Annals of Thoracic Surgery, 97(1): 78-85
Fadahunsi, O., Romeo, M. (2014) Cardiac tamponade - presentation of type A aortic dissection. Journal of Community Hospital Internal Medicine Perspectives, 4(5): 25449
Fan, P.Y., Chen, C.Y., Lee, C.C., Liu, K.S., Wu, V.C., Fan, P.C., et al. (2019) Impact of renal dysfunction on surgical outcomes in patients with aortic dissection. Medicine (Baltimore), 98(20): e15453
Gawinecka, J., Schönrath, F., von Eckardstein, A. (2017) Acute aortic dissection: pathogenesis, risk factors and diagnosis. Swiss Medical Weekly, 147: w14489
Helgason, D., Helgadottir, S., Ahlsson, A., Gunn, J., Hjortdal, V., Hansson, E.C., et al. (2021) Acute Kidney Injury After Acute Repair of Type A Aortic Dissection. Annals of Thoracic Surgery, 111(4): 1292-1298
Kimura, N., Aizawa, K., Kawahito, K., Itagaki, R., Yamaguchi, A., Misawa, Y., et al. (2019) Outcomes of Early-Onset Acute Type A Aortic Dissection ― Influence of Etiologic Factors. Circulation Journal, 83(2): 285-294
Kouchoukos, N.T., Kulik, A., Haynes, M., Castner, C.F. (2019) Early Outcomes After Thoracoabdominal Aortic Aneurysm Repair With Hypothermic Circulatory Arrest. Annals of Thoracic Surgery, 108(5): 1338-1343
Kreibich, M., Chen, Z., Rylski, B., Bavaria, J.E., Brown, C.R., Branchetti, E., et al. (2019) Outcome after aortic, axillary, or femoral cannulation for acute type A aortic dissection. Journal of Thoracic and Cardiovascular Surgery, 158(1): 27-34
Landenhed, M., Engström, G., Gottsäter, A., Caulfield, M.P., Hedblad, B., Newton-Cheh, C., et al. (2015) Risk profiles for aortic dissection and ruptured or surgically treated aneurysms: a prospective cohort study. Journal of the American Heart Association, 4(1): e001513
Latt, K.K., Vasiliyev, K.N., Bayandin, N.L., Stupin, V.A. (2019) Faktory riska khirurgicheskogo lecheniia u bol'nykh s ostrym rassloeniem aorty tipa A /Risk factors of surgical treatment of acute aortic dissection type A. Khirurgiia (Mosk), in Russian only, (3):15-20
Lee, T.C., Kon, Z., Cheema, F.H., Grau-Sepulveda, M.V., Englum, B., Kim, S., et al. (2018) Contemporary management and outcomes of acute type A aortic dissection: An analysis of the STS adult cardiac surgery database. Journal of Cardiac Surgery, 33(1): 7-18
Martin, C.E., Forteza, A., Perez, E., Lopez, M.J., Centeno, J., Blazquez, J.A., et al. (2008) Predictors of mortality and reoperation in Acute type A aortic dissection surgery: 18 years of experience. Revista Española de Cardiología (English Edition), 61(10): 1050-1060
Niclauss, L., Delay, D., Ferrari, E., Pretre, R. (2014) Impact of preoperative central neurologic dysfunction on patients undergoing emergency surgery for type A dissection. Annals of Vascular Surgery, 28(5): 1227-1235
Nienaber, C.A., Clough, R.E., Sakalihasan, N., Suzuki, T., Gibbs, R., Mussa, F., et al. (2016) Aortic dissection. Nat Rev Dis Primers, 2: 16071
Ram, E., Krupik, Y., Lipey, A., Shinfeld, A., Peled, Y., Kogan, A., et al. (2019) Is Axillary Better Than Femoral Artery Cannulation in Repair of Acute Type A Aortic Dissection?. Innovations, 14(2): 124-133
Rosinski, B.F., Idrees, J.J., Roselli, E.E., Germano, E., Pasadyn, S.R., Lowry, A.M., et al. (2019) Cannulation strategies in acute type A dissection repair: A systematic axillary artery approach. Journal of Thoracic and Cardiovascular Surgery, 158(3): 647-659.e5
Schoenrath, F., Laber, R., Maralushaj, M., Henzi, D., Caliskan, E.I., Seifert, B., et al. (2016) Survival, Neurologic Injury, and Kidney Function after Surgery for Acute Type A Aortic Dissection. Thorac Cardiovasc Surg, 64(2): 100-107
Tsai, T.T., Trimarchi, S., Nienaber, C.A. (2009) Acute Aortic Dissection: Perspectives from the International Registry of Acute Aortic Dissection (IRAD). European Journal of Vascular and Endovascular Surgery, 37(2): 149-159
Urbanski, P.P., Lenos, A., Irimie, V., Bougioukakis, P., Zacher, M., Diegeler, A. (2016) Acute aortic dissection involving the root: operative and long-term outcome after curative proximal repair. Interactive CardioVascular and Thoracic Surgery, 22(5): 620-626
Zdravković, R., Redžek, A., Šušak, S., Tatić, M., Videnović, N., Majdevac, S., Vujić, V., Vučković-Karan, J., Miljković, T., Velicki, L. (2020) In-hospital mortality predictors after surgery for Stanford type A aortic dissection: Single-center five-year experience. Srpski arhiv za celokupno lekarstvo, vol. 148, br. 9-10, str. 541-547
Zhu, S., Zheng, T., Qiao, Z.Y., Chen, L., Ou, J.F., Fang, W.G., et al. (2020) Acute Aortic Dissection in Young Adult Patients: Clinical Characteristics, Management, and Perioperative Outcomes. Journal of Investigative Surgery, 33(3): 211-217
 

O članku

jezik rada: engleski
vrsta rada: originalan članak
DOI: 10.2298/SARH210425072N
primljen: 25.04.2021.
revidiran: 22.08.2021.
prihvaćen: 23.08.2021.
objavljen onlajn: 31.08.2021.
objavljen u SCIndeksu: 07.01.2022.

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