Association between false lumen segmental arteries and spinal cord ischemia in type A acute aortic dissection.
J Cardiovasc Surg (Torino)
; 61(2): 226-233, 2020 Apr.
Article
in En
| MEDLINE
| ID: mdl-30465415
ABSTRACT
BACKGROUND:
Spinal cord ischemia (SCI) and paraplegia are complications of surgery for type A acute aortic dissection (TAAAD). Since the segmental arteries play a key role in SCI, this study evaluated the association between SCI and false lumen segmental arteries (FLSAs segmental arteries originating from the false lumen).METHODS:
The study included 101 consecutive TAAAD patients (mean age, 66±13; range, 34-89 years) who underwent surgery from January 2011 to April 2017. The diagnosis of TAAAD and the number of FSLAs were determined by preoperative computed tomography (CT). Patients were divided into two groups according to the number of FLSAs at the Th9-L2 level Group A (N.=13), ≥8 FLSAs; and group B (N.=88), ≤7 FLSAs. Preoperative, perioperative, and postoperative findings were compared between the groups, and risk factors for SCI were evaluated.RESULTS:
The frequency of preoperative paralysis was significantly higher in Group A than Group B (P=.0070). The overall incidence of postoperative SCI was 8% (8/101) and significantly higher in Group A than Group B (5/13 [45%] vs. 3/88 (4%), P<0.0001). Hospital mortality was 8% (8/101) and significantly higher in Group A than Group B (3/13 [23%] vs. 5/88 [6%], P=.0302). Multivariate analysis showed that the independent risk factors for SCI were ≥8 FLSAs at Th9-L2 (odds ratio [OR], 20.4; 95% confidence interval [95% CI], 3.34-124.9, P=0.0011) and diabetes mellitus (OR, 22.3; 95% CI, 1.69-294.5; P=0.0184).CONCLUSIONS:
In patients who underwent surgery for TAAAD, ≥8 FLSAs at the Th9-L2 levels on preoperative CT was a risk factor for SCI.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Cause of Death
/
Aortic Aneurysm, Thoracic
/
Blood Vessel Prosthesis Implantation
/
Spinal Cord Ischemia
/
Vascular Malformations
/
Aortic Dissection
Type of study:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Language:
En
Journal:
J Cardiovasc Surg (Torino)
Year:
2020
Document type:
Article
Affiliation country: