Department of Cardiothoracic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 210008, Nanjing, China.
BMC Anesthesiol. 2021 Feb 5;21(1):35. doi: 10.1186/s12871-021-01252-6.
Extracorporeal membrane oxygenation (ECMO) support may be considered to reduce mortality but survival and clinical outcomes are uncertain after Stanford type A Aortic dissection (TAAD). We analyzed the data of TAAD patients with postoperative ECMO support in our institution to investigate clinical outcomes.
In this retrospective cohort study, all clinical data of TAAD patients with postoperative ECMO support from January 2013 to October 2019 in our institution were harvested. Cases with redo or incomplete records were excluded.
22 cases were enrolled, 18 male and 4 female. The mean age was52.85±10.91 years. 20 patients underwent VA-ECMO treatment and 2 patients received VV-ECMO support. The support time was92.54±78.71 hours. 9 patients were successfully weaned from ECMO. 30-day in-hospital survival rate was 27.27 % (6/22). The follow-up duration is from 5 to 74 months. The median follow-up time is 35 months. Only four patients were still alive at the end of the follow-up period.
The mortality of TAAD patients with postoperativesevere circulatory and respiratory dysfunctions is high. ECMO would be considered as a valuable contribution to save lives. But more experience needs to be accumulated to improve clinical outcome.
体外膜肺氧合（ECMO）支持可能被认为可以降低死亡率，但斯坦福 A 型主动脉夹层（TAAD）术后的存活率和临床结果仍不确定。我们分析了我院接受术后 ECMO 支持的 TAAD 患者的数据，以调查临床结果。
在这项回顾性队列研究中，我们收集了我院 2013 年 1 月至 2019 年 10 月期间所有接受术后 ECMO 支持的 TAAD 患者的临床数据。排除再次手术或记录不完整的病例。
共纳入 22 例患者，其中男 18 例，女 4 例。平均年龄为 52.85±10.91 岁。20 例患者接受 VA-ECMO 治疗，2 例患者接受 VV-ECMO 支持。支持时间为 92.54±78.71 小时。9 例患者成功撤离 ECMO。30 天院内生存率为 27.27%（6/22）。随访时间从 5 至 74 个月不等，中位随访时间为 35 个月。随访结束时，仅有 4 例患者存活。
术后出现严重循环和呼吸功能障碍的 TAAD 患者死亡率较高。ECMO 被认为是挽救生命的有价值的治疗手段。但需要更多的经验来改善临床结果。
