Samanidis George, Kanakis Meletios, Georgiou Charalampos, Perreas Konstantinos
Department of Adult Cardiac Surgery, Onassis Cardiac Surgery Center, Athens 17674, Greece.
Department of Pediatric and Congenital Heart Surgery, Onassis Cardiac Surgery Center, Athens 17674, Greece.
World J Cardiol. 2022 Apr 26;14(4):231-238. doi: 10.4330/wjc.v14.i4.231.
Acute type A aortic dissection (ATAAD) is a life-threatening disease associated with high morbidity and mortality.
To evaluate the diameter of dissected ascending aorta in patients diagnosed with ATAAD and whether the aortic diameter is associated with preoperative adverse events.
A total of 108 patients diagnosed with ATAAD who underwent emergency operation under hypothermic circulatory arrest were enrolled in this study. Demographic characteristics and perioperative data were recorded. In all patients, preoperative chest and abdomen computed tomography (CT) scans were performed.
Median age of the patients was 61.5 (52.5-70.5) years and median body mass index (BMI) was 28.2 (25.1-32.6) cm. The number of female patients was 37 (25%). Median diameter of the ascending aorta was 5.0 (4.5-6) cm and 53.8% of the patients had an aortic diameter < 5.0 cm, while 32.3% of the patients had an aortic diameter of 4.5cm and 72.0% had an ascending aorta diameter < 5.5 cm. The diameter of the ascending aorta did not differ in patients with without preoperative adverse events: Preoperative neurological dysfunction ( = 0.53) and hemodynamic instability ( = 0.43). Median age of patients with preoperative hemodynamic instability was 65 (57.5-74) years, while it was 60 (51-68) years in patients without ( = 0.04).
Although current guidelines suggest replacing the ascending aorta with a diameter > 5.5 cm, most of the patients with ATAAD had an aortic diameter of less than 5.5 cm. The diameter of the ascending aorta in patients diagnose with ATAAD is not associated with preoperative adverse events.
急性A型主动脉夹层（ATAAD）是一种危及生命的疾病，发病率和死亡率都很高。
评估被诊断为ATAAD的患者中夹层升主动脉的直径，以及主动脉直径是否与术前不良事件相关。
本研究纳入了108例被诊断为ATAAD并在低温循环停止下接受急诊手术的患者。记录人口统计学特征和围手术期数据。所有患者均进行了术前胸部和腹部计算机断层扫描（CT）。
患者的中位年龄为61.5（52.5 - 70.5）岁，中位体重指数（BMI）为28.2（25.1 - 32.6）cm。女性患者有37例（25%）。升主动脉的中位直径为5.0（4.5 - 6）cm，53.8%的患者主动脉直径<5.0 cm，而32.3%的患者主动脉直径为4.5cm，72.0%的患者升主动脉直径<5.5 cm。术前有无不良事件的患者升主动脉直径无差异：术前神经功能障碍（P = 0.53）和血流动力学不稳定（P = 0.43）。术前血流动力学不稳定患者的中位年龄为65（57.5 - 74）岁，而无血流动力学不稳定患者的中位年龄为60（51 - 68）岁（P = 0.04）。
尽管目前的指南建议替换直径>5.5 cm的升主动脉，但大多数ATAAD患者的主动脉直径小于5.5 cm。被诊断为ATAAD的患者升主动脉直径与术前不良事件无关。
