Is Previous Cardiac Surgery a Risk Factor for Short and Mid-term Mortality Following Total Aortic Arch Replacement in Patients with Stanford Type A Aortic Dissection?

Background The aim of this study was to evaluate if the previous cardiac surgery (PCS) is the risk factor for short- and mid-term mortality following total aortic arch replacement in patients with Stanford type A aortic dissection. Methods Between February 2009 and February 2012, a total of 384 pati...

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Bibliographic Details
Published in:Heart, lung & circulation lung & circulation, 2015-11, Vol.24 (11), p.1111-1117
Main Authors: Ge, Yi-Peng, MD, Li, Cheng-Nan, MD, Chen, Lei, MD, Liu, Wei, MD, Cheng, Li-Jian, MD, Liu, Yong-Min, MD, Zheng, Jun, MD, Ma, Wei-Guo, Zhu, Jun-Ming, MD, Sun, Li-Zhong, MD
Format: Article
Language:English
Subjects:
Adult
Aorta, Thoracic - surgery
Aortic arch replacement
Aortic Rupture - etiology
Aortic Rupture - mortality
Aortic Rupture - surgery
Cardiac Surgical Procedures - adverse effects
Cardiovascular
Disease-Free Survival
Female
Follow-Up Studies
Hospital Mortality
Humans
Male
Middle Aged
Mortality
Postoperative Complications - mortality
Postoperative Complications - surgery
Previous cardiac surgery
Stanford type A aortic dissection
Survival
Survival Rate
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Summary:Background The aim of this study was to evaluate if the previous cardiac surgery (PCS) is the risk factor for short- and mid-term mortality following total aortic arch replacement in patients with Stanford type A aortic dissection. Methods Between February 2009 and February 2012, a total of 384 patients who suffered Stanford type A aortic dissection involving aortic arch underwent total aortic arch replacement with frozen elephant trunk. Of these patients, 36 patients had PCS. Logistic regression was used to identify if the previous cardiac surgery was the risk factor for in-hospital mortality. Propensity score-matching (1:1 match) was used to yield patients from the primary surgery group who matched PCS group with respect to pre-operative clinical characteristics and post-operative complications. Survival analysis and differences between the two groups were performed by the Kaplan-Meier estimate and the log-rank test. Results The overall in-hospital mortality was 8%. Logistic multiple regression identified that cardiopulmonary bypass time≥ 300 minutes (OR=12.05, p
ISSN:1443-9506
1444-2892
DOI:10.1016/j.hlc.2015.04.066