Clinical study of the patients with Stanford type A aortic dissection received urgent surgery / 中华急诊医学杂志

ABSTRACT

Objective To analyse the factors influencing the death of patients with aortic dissection (Stanford type A arota dissection) who underwent urgent surgery.Methods The clinical data of 197 patients with aortic dissection (Stanford type A arota dissection) treated with urgent surgery from the First Affiliate Hosiptal of Xinjiang Medical University were retrospectively analyzed between January 2009 and June 2015 in order to determine the factors influencing the early-mortality.Results Of them,23 patietns dead.In univariant analysis,the rate of mortality was 11.68％.The following factors at admission were independetly associated with early-mortalityhypertension,coronary atherosclerotic heart disease,LVEF ≤ 50％,time consumed for CPB ≥ 180 min,time required for cross-clamping aorta ≥ 120 min,Cr ≥ 130 μmol/L,rethoracotomy for hemostasis (P ＜0.05).The preoperative renal failure (Cr≥130 μmol/L) and time consumed for cross-clamping aorta ≥ 120 min were strongly associated with the early-mortality based on the logistic regression analyses.Conclusions The risk of aortic dissection surgery is very high,and it is mondatory to carefully evaluate the patient' s general condition and the indications during peroperative period,and to take active measures to shorten the time of clamping aorta and total operation time in order to reduce the risk of operation and increase the survival rate of patients.