Key result
Persistent malperfusion syndrome following central repair for acute type A aortic dissection was associated with a hospital mortality rate of 28.6% compared to 4.3% in patients without persistent MPS (P=0.061).
Why the study?
The impact of persistent malperfusion syndrome following central repair of acute type A aortic dissection on outcomes was investigated.
Does persistent malperfusion syndrome following central repair of acute type A aortic dissection worsen early clinical outcomes compared to resolved malperfusion syndrome?
Cohort (n=30)
No
Does persistent malperfusion syndrome following central repair of acute type A aortic dissection worsen early clinical outcomes compared to resolved malperfusion syndrome?
Absolute Event Rate: 28.6% vs 4.3%
p-value: p=0.061
Persistent malperfusion syndrome following central repair for acute type A aortic dissection is associated with significantly higher morbidity, including the need for hemodialysis and intestinal resection, and a trend toward higher hospital mortality.
Persistent MPS after type A repair flags high morbidity risk; leaves open whether targeted malperfusion strategies improve outcomes.
We investigated impact of persistent malperfusion syndrome (MPS) following central repair of acute type A aortic dissection (ATAAD) on outcomes. Thirty patients who underwent central repair for ATAAD with MPS were included. Patients were divided into two groups:23 patients without MPS following central repair (No-MPS group) and 7 with MPS (Persistent-MPS group). The mean age was 66.8±9.6 and 59.4±13.4 years in the No-MPS and Persistent-MPS groups, respectively (P=0.176). Preoperative MPS included the left coronary artery (n=3), brain (n=3), abdomen (n=7), and extremities (n=11) in the No-MPS group. In the Persistent-MPS group, the right coronary (n=1), brain (n=2), abdomen (n=3), and extremities (n=5) were observed. In the No-MPS group, one patient died of extensive cerebral infarction (4.3%). In the Persistent-MPS group, 2 patients died of sepsis and multi-organ failure, respectively (28.6%) (P=0.061). The Persistent-MPS group had more patients requiring hemodialysis than the No-MPS group (P=0.009). Three patients underwent intestinal resection due to persistent MPS (P<0.001). Persistent MPS following central repair for ATAAD significantly contributed to outcomes. J. Med. Invest. 71 : 158-161, February, 2024.
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Fukunaga et al. (2024) conducted a cohort in Acute type A aortic dissection with preoperative malperfusion syndrome (n=30). Persistent malperfusion syndrome (MPS) vs. No persistent MPS following central repair was evaluated on Hospital death (p=0.061). Persistent malperfusion syndrome following central repair for acute type A aortic dissection was associated with a hospital mortality rate of 28.6% compared to 4.3% in patients without persistent MPS (P=0.061).
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