Key result
Review analyzes surgical management and predictors of neurological injury during type A aortic dissection.
Why the study?
Stroke events are very common in acute type A aortic dissection and cerebral malperfusion may occur before or after surgery despite cerebral protection strategies.
What are the outcomes and predictors of neurological injuries during surgical management of type A aortic dissection?
What are the outcomes and predictors of neurological injuries during surgical management of type A aortic dissection?
This review analyzes neurological injuries during type A aortic dissection surgery to identify predictors and outcomes based on surgical management and cerebral protection strategies.
Cerebral protection adjuncts in acute type A dissection need prospective validation; leaves open optimal RCP versus antegrade perfusion strategy.
Stroke events are very common in acute type A aortic dissection. Cerebral malperfusion could manifest at presentation due to prolonged arch vessels hypoperfusion or develop after surgery for inadequate cerebral protection during arch repair. To reduce this detrimental complication there are several adjuncts that can be adopted for cerebral protection such as direct antegrade or retrograde cerebral perfusion (RCP) and use period of deep to moderate hypothermic circulatory arrest time; however, they are often insufficient as preoperative malperfusion already caused irreversible ischemic damages. The aim of the current review article is to analyze the principal series reporting on neurological injuries during type A aortic dissection to focus on the outcomes according to the type of surgical management and identify possible predictors to better manage this complication.
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Pacini et al. (2018) conducted a review in Acute type A aortic dissection. Surgical management and cerebral protection strategies was evaluated on Neurological injuries. This review analyzes principal series reporting on neurological injuries during type A aortic dissection to evaluate outcomes by surgical management type and identify predictors of complications.