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Differential outcom...
Differential outcomes of open and clamp-on distal anastomosis techniques in acute type A aortic dissection
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- Geirsson, Arnar (författare)
- Section of Cardiac Surgery, Yale University School of Medicine, New Haven CT, USA
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- Shioda, Kayoko (författare)
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven CT, USA
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- Olsson, Christian (författare)
- Karolinska Institutet
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- Ahlsson, Anders (författare)
- Karolinska Institutet
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- Gunn, Jarmo (författare)
- Heart Center, Turku University Hospital and University of Turku, Turku, Finland
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- Hansson, Emma C., 1985 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
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- Hjortdal, Vibeke (författare)
- Department of Thoracic and Cardiovascular Surgery, Aarhus University Hospital, Skejby, Denmark
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- Jeppsson, Anders, 1960 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
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- Mennander, Ari (författare)
- Heart Center Tampere University Hospital, Tampere, Finland
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- Wickbom, Anders, 1987- (författare)
- Örebro universitet,Institutionen för medicinska vetenskaper,Department of Cardiothoracic and Vascular Surgery
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- Zindovic, Igor (författare)
- Department of Cardiothoracic Surgery, Skane University Hospital, Lund, Sweden
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- Gudbjartsson, Tomas (författare)
- Landspitali University Hospital and Faculty of Medicine, University of Iceland, Reykjavik, Iceland
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(creator_code:org_t)
- Elsevier, 2019
- 2019
- Engelska.
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Ingår i: Journal of Thoracic and Cardiovascular Surgery. - : Elsevier. - 0022-5223 .- 1097-685X. ; 157:5, s. 1750-1758
- Relaterad länk:
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http://www.jtcvs.org...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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http://kipublication...
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https://gup.ub.gu.se...
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Abstract
Ämnesord
Stäng
- Objectives: Open-distal anastomosis is the preferred technique over clamp-on technique for surgical repair of acute type A aortic dissection (ATAAD). The aim of this study was to define how outcomes of ATAAD were affected by the use of either technique.Methods: Nordic Consortium for Acute Type A Aortic Dissection includes 8 academic cardiothoracic hospitals in 4 Nordic countries. The cohort consisted of 1134 patients, 153 clamp-on and 981 open-distal, from 2005 to 2014.Results: Patients who underwent operation with the clamp-on were younger, more frequently had coronary artery disease, bicuspid aortic valve, hypotension/shock or syncope, and a greater PennClass than open-distal patients. Postoperative cerebral vascular accident occurred less frequently in clamp-on (14/153, 10%) compared with the open-distal group (190/981, 20%). Clamp-on had greater 30-day mortality (39/153, 25%) than the open-distal group (158/981, 16%), and 5-year survival was also worse in clamp-on (61.8% +/- 4.4%) compared with the open-distal group (73.0% +/- 1.6%). The open-distal technique was used more frequently in greater-volume hospitals but was not independently associated with 30-day mortality. Preoperative condition was an independent risk factor whereas hospital volume and later year of operation were beneficial in regard to short-term outcome. Open-distal was independently associated with improved mid-term survival.Conclusions: Patients who underwent operation with the clamp-on were sicker on presentation and had worse short-and mid-term survival compared with the open-distal group. Patients in the open-distal group had greater rates of cerebrovascular complications. The results support the routine use of open-distal anastomosis as the primary operative strategy for ATAAD, although clamp-on can be performed successfully in select cases.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Lungmedicin och allergi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Respiratory Medicine and Allergy (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Nyckelord
- aortic dissection
- hypothermic arrest
- surgical techniques
- outcomes
- survival
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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Geirsson, Arnar
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Shioda, Kayoko
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Olsson, Christia ...
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Ahlsson, Anders
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Gunn, Jarmo
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Hansson, Emma C. ...
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Hjortdal, Vibeke
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Jeppsson, Anders ...
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Mennander, Ari
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Wickbom, Anders, ...
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Zindovic, Igor
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Gudbjartsson, To ...
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- Om ämnet
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Kardiologi
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Lungmedicin och ...
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Kirurgi
- Artiklar i publikationen
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Journal of Thora ...
- Av lärosätet
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Örebro universitet
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Karolinska Institutet
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Göteborgs universitet