PMID- 18564295
OWN - NLM
STAT- MEDLINE
DCOM- 20090303
LR  - 20221207
IS  - 1540-8191 (Electronic)
IS  - 0886-0440 (Linking)
VI  - 23
IP  - 5
DP  - 2008 Sep-Oct
TI  - Predictors and outcomes associated with intraoperative aortic dissection in 
      cardiac surgery.
PG  - 422-5
LID - 10.1111/j.1540-8191.2008.00624.x [doi]
AB  - OBJECTIVE: Although rare, aortic dissection is one of the most devastating, but 
      least studied, intraoperative complications. The objective of this study was to 
      assess risk factors of aortic dissection and assess outcomes in patients with 
      aortic dissection experience. METHODS: A study from a 10-year hospitalization 
      cohort (N = 12,907) with prospective data collection was conducted. Patients 
      without aortic dissection were matched to 33 aortic dissection patients 3:1 on 
      the type of procedure. The study examined 24 potential confounding risk factors 
      and 12 outcome variables. RESULTS: Univariate analysis on potential confounding 
      risk factors revealed two significant risk factors. There was a significant 
      difference between aortic dissection and nonaortic dissection patients with New 
      York Heart Association (NYHA) functional class (p = 0.03). Patients with aortic 
      dissection were more likely to be in Class I or II. Patients with aortic 
      dissection had significantly longer perfusion time (p = 0.008). There was a 
      significant difference between patients with and without aortic dissection on 
      four outcome variables. Patients with an aortic dissection were more likely to 
      need prolonged ventilation (p = 0.046), have renal failure (p = 0.005), require 
      intraaortic balloon pump (IABP) (0.043), and have a higher mortality rate (p < 
      0.001). CONCLUSION: Aortic dissection occurs infrequently during coronary artery 
      bypass grafting, but is a devastating complication and greatly increases 
      morbidity. Although few patients dissect intraoperatively, this study attempted 
      to identify predictors that may label a patient as high risk for possible aortic 
      dissection. Although two factors in this study were statistically significant, 
      they are not reliable preoperative predictors of high-risk patients that can be 
      used to screen patients and help prevent aortic dissection and its sequela.
FAU - Hurt, Amber
AU  - Hurt A
AD  - Department of Surgery, Good Samaritan Hospital, Cincinnati, Ohio 45220, USA.
FAU - Smith, J Michael
AU  - Smith JM
FAU - Engel, Amy M
AU  - Engel AM
LA  - eng
PT  - Journal Article
DEP - 20080618
PL  - United States
TA  - J Card Surg
JT  - Journal of cardiac surgery
JID - 8908809
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Dissection/*etiology/mortality
MH  - Aortic Aneurysm/*etiology/mortality
MH  - Cardiovascular Surgical Procedures/*adverse effects/mortality
MH  - Case-Control Studies
MH  - Cohort Studies
MH  - Confounding Factors, Epidemiologic
MH  - Female
MH  - Health Status Indicators
MH  - Hospitalization
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Perioperative Care
MH  - Prospective Studies
MH  - Risk Factors
MH  - *Thoracic Surgery
MH  - Treatment Outcome
EDAT- 2008/06/20 09:00
MHDA- 2009/03/04 09:00
CRDT- 2008/06/20 09:00
PHST- 2008/06/20 09:00 [pubmed]
PHST- 2009/03/04 09:00 [medline]
PHST- 2008/06/20 09:00 [entrez]
AID - JCS624 [pii]
AID - 10.1111/j.1540-8191.2008.00624.x [doi]
PST - ppublish
SO  - J Card Surg. 2008 Sep-Oct;23(5):422-5. doi: 10.1111/j.1540-8191.2008.00624.x. 
      Epub 2008 Jun 18.