Malperfusion in acute type A aortic dissection: An update from the Nordic Consortium for Acute Type A Aortic Dissection.
To access publisher's full text version of this article click on the hyperlink below To evaluate the effect of preoperative malperfusion on 30-day and late mortality and postoperative complications using data from the Nordic Consortium for Acute Type A Aortic Dissection (ATAAD) registry. We stu...
Published in: | The Journal of Thoracic and Cardiovascular Surgery |
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Main Authors: | , , , , , , , , , , , , , , , |
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Format: | Article in Journal/Newspaper |
Language: | English |
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Mosby-Elsevier
2019
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Online Access: | http://hdl.handle.net/2336/620917 https://doi.org/10.1016/j.jtcvs.2018.10.134 |
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ftlandspitaliuni:oai:www.hirsla.lsh.is:2336/620917 |
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Hirsla - Landspítali University Hospital research archive |
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ftlandspitaliuni |
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English |
topic |
aorta dissection malperfusion Slagæðargúlpur Skurðlækningar Postoperative Complications Aneurysm Dissecting |
spellingShingle |
aorta dissection malperfusion Slagæðargúlpur Skurðlækningar Postoperative Complications Aneurysm Dissecting Zindovic, Igor Gudbjartsson, Tomas Ahlsson, Anders Fuglsang, Simon Gunn, Jarmo Hansson, Emma C Hjortdal, Vibeke Järvelä, Kati Jeppsson, Anders Mennander, Ari Olsson, Christian Pan, Emily Sjögren, Johan Wickbom, Anders Geirsson, Arnar Nozohoor, Shahab Malperfusion in acute type A aortic dissection: An update from the Nordic Consortium for Acute Type A Aortic Dissection. |
topic_facet |
aorta dissection malperfusion Slagæðargúlpur Skurðlækningar Postoperative Complications Aneurysm Dissecting |
description |
To access publisher's full text version of this article click on the hyperlink below To evaluate the effect of preoperative malperfusion on 30-day and late mortality and postoperative complications using data from the Nordic Consortium for Acute Type A Aortic Dissection (ATAAD) registry. We studied 1159 patients who underwent ATAAD surgery between January 2005 and December 2014 at 8 Nordic centers. Multivariable logistic and Cox regression analyses were performed to identify independent predictors of 30-day and late mortality. Preoperative malperfusion was identified in 381 of 1159 patients (33%) who underwent ATAAD surgery. Thirty-day mortality was 28.9% in patients with preoperative malperfusion and 12.1% in those without. Independent predictors of 30-day mortality included any malperfusion (odds ratio, 2.76; 95% confidence interval [CI], 1.94-3.93), cardiac malperfusion (odds ratio, 2.37; 95% CI, 1.34-4.17), renal malperfusion (odds ratio, 2.38; 95% CI, 1.23-4.61) and peripheral malperfusion (odds ratio, 1.95; 95% CI, 1.26-3.01). Any malperfusion (hazard ratio, 1.72; 95% CI, 1.21-2.43), cardiac malperfusion (hazard ratio, 1.89; 95% CI, 1.24-2.87) and gastrointestinal malperfusion (hazard ratio, 2.25; 95% CI, 1.18-4.26) were predictors of late mortality. Malperfusion was associated with significantly poorer survival at 1, 3, and 5 years (95.0% ± 0.9% vs 88.7% ± 1.9%, 90.1% ± 1.3% vs 84.0% ± 2.4%, and 85.4% ± 1.7% vs 80.8% ± 2.7%; log rank P = .009). Malperfusion has a significant influence on early and late outcomes in ATAAD surgery. Management of preoperative malperfusion remains a major challenge in reducing mortality associated with surgical treatment of ATAAD. University of Iceland Research Fund Landspitali Research Fund Mats Kleberg Foundation |
author2 |
1 Department of Clinical Sciences and Department of Cardiothoracic Surgery, Lund University, Skane University Hospital, Lund, Sweden. Electronic address: igor.zindovic@med.lu.se. 2 Landspitali University Hospital and Faculty of Medicine, University of Iceland, Reykjavik, Iceland. 3 Department of Cardiothoracic and Vascular Surgery, Orebro University Hospital and School of Health and Medicine, Orebro University, Orebro, Sweden. 4 Department of Thoracic and Cardiovascular Surgery, Aarhus University Hospital, Skejby, Denmark. 5 Heart Center, Turku University Hospital and University of Turku, Turku, Finland. 6 Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 7 Heart Center, Tampere University Hospital, Tampere, Finland. 8 Department of Thoracic and Cardiovascular Surgery, Karolinska University Hospital, Stockholm, Sweden. 9 Department of Clinical Sciences and Department of Cardiothoracic Surgery, Lund University, Skane University Hospital, Lund, Sweden. 10 Landspitali University Hospital and Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Section of Cardiac Surgery, Yale University School of Medicine, New Haven, Conn. |
format |
Article in Journal/Newspaper |
author |
Zindovic, Igor Gudbjartsson, Tomas Ahlsson, Anders Fuglsang, Simon Gunn, Jarmo Hansson, Emma C Hjortdal, Vibeke Järvelä, Kati Jeppsson, Anders Mennander, Ari Olsson, Christian Pan, Emily Sjögren, Johan Wickbom, Anders Geirsson, Arnar Nozohoor, Shahab |
author_facet |
Zindovic, Igor Gudbjartsson, Tomas Ahlsson, Anders Fuglsang, Simon Gunn, Jarmo Hansson, Emma C Hjortdal, Vibeke Järvelä, Kati Jeppsson, Anders Mennander, Ari Olsson, Christian Pan, Emily Sjögren, Johan Wickbom, Anders Geirsson, Arnar Nozohoor, Shahab |
author_sort |
Zindovic, Igor |
title |
Malperfusion in acute type A aortic dissection: An update from the Nordic Consortium for Acute Type A Aortic Dissection. |
title_short |
Malperfusion in acute type A aortic dissection: An update from the Nordic Consortium for Acute Type A Aortic Dissection. |
title_full |
Malperfusion in acute type A aortic dissection: An update from the Nordic Consortium for Acute Type A Aortic Dissection. |
title_fullStr |
Malperfusion in acute type A aortic dissection: An update from the Nordic Consortium for Acute Type A Aortic Dissection. |
title_full_unstemmed |
Malperfusion in acute type A aortic dissection: An update from the Nordic Consortium for Acute Type A Aortic Dissection. |
title_sort |
malperfusion in acute type a aortic dissection: an update from the nordic consortium for acute type a aortic dissection. |
publisher |
Mosby-Elsevier |
publishDate |
2019 |
url |
http://hdl.handle.net/2336/620917 https://doi.org/10.1016/j.jtcvs.2018.10.134 |
genre |
Iceland |
genre_facet |
Iceland |
op_source |
The Journal of thoracic and cardiovascular surgery |
op_relation |
https://www.sciencedirect.com/science/article/pii/S0022522318329283 Malperfusion in acute type A aortic dissection: An update from the Nordic Consortium for Acute Type A Aortic Dissection. 2019,157(4):1324-1333 J Thorac Cardiovasc Surg 1097-685X 30578066 doi:10.1016/j.jtcvs.2018.10.134 http://hdl.handle.net/2336/620917 Journal of thoracic and cardiovascular surgery |
op_rights |
National Consortium - Landsaðgangur |
op_doi |
https://doi.org/10.1016/j.jtcvs.2018.10.134 |
container_title |
The Journal of Thoracic and Cardiovascular Surgery |
container_volume |
157 |
container_issue |
4 |
container_start_page |
1324 |
op_container_end_page |
1333.e6 |
_version_ |
1766041937168564224 |
spelling |
ftlandspitaliuni:oai:www.hirsla.lsh.is:2336/620917 2023-05-15T16:51:49+02:00 Malperfusion in acute type A aortic dissection: An update from the Nordic Consortium for Acute Type A Aortic Dissection. Zindovic, Igor Gudbjartsson, Tomas Ahlsson, Anders Fuglsang, Simon Gunn, Jarmo Hansson, Emma C Hjortdal, Vibeke Järvelä, Kati Jeppsson, Anders Mennander, Ari Olsson, Christian Pan, Emily Sjögren, Johan Wickbom, Anders Geirsson, Arnar Nozohoor, Shahab 1 Department of Clinical Sciences and Department of Cardiothoracic Surgery, Lund University, Skane University Hospital, Lund, Sweden. Electronic address: igor.zindovic@med.lu.se. 2 Landspitali University Hospital and Faculty of Medicine, University of Iceland, Reykjavik, Iceland. 3 Department of Cardiothoracic and Vascular Surgery, Orebro University Hospital and School of Health and Medicine, Orebro University, Orebro, Sweden. 4 Department of Thoracic and Cardiovascular Surgery, Aarhus University Hospital, Skejby, Denmark. 5 Heart Center, Turku University Hospital and University of Turku, Turku, Finland. 6 Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 7 Heart Center, Tampere University Hospital, Tampere, Finland. 8 Department of Thoracic and Cardiovascular Surgery, Karolinska University Hospital, Stockholm, Sweden. 9 Department of Clinical Sciences and Department of Cardiothoracic Surgery, Lund University, Skane University Hospital, Lund, Sweden. 10 Landspitali University Hospital and Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Section of Cardiac Surgery, Yale University School of Medicine, New Haven, Conn. 2019-05 http://hdl.handle.net/2336/620917 https://doi.org/10.1016/j.jtcvs.2018.10.134 en eng Mosby-Elsevier https://www.sciencedirect.com/science/article/pii/S0022522318329283 Malperfusion in acute type A aortic dissection: An update from the Nordic Consortium for Acute Type A Aortic Dissection. 2019,157(4):1324-1333 J Thorac Cardiovasc Surg 1097-685X 30578066 doi:10.1016/j.jtcvs.2018.10.134 http://hdl.handle.net/2336/620917 Journal of thoracic and cardiovascular surgery National Consortium - Landsaðgangur The Journal of thoracic and cardiovascular surgery aorta dissection malperfusion Slagæðargúlpur Skurðlækningar Postoperative Complications Aneurysm Dissecting Article 2019 ftlandspitaliuni https://doi.org/10.1016/j.jtcvs.2018.10.134 2022-05-29T08:22:25Z To access publisher's full text version of this article click on the hyperlink below To evaluate the effect of preoperative malperfusion on 30-day and late mortality and postoperative complications using data from the Nordic Consortium for Acute Type A Aortic Dissection (ATAAD) registry. We studied 1159 patients who underwent ATAAD surgery between January 2005 and December 2014 at 8 Nordic centers. Multivariable logistic and Cox regression analyses were performed to identify independent predictors of 30-day and late mortality. Preoperative malperfusion was identified in 381 of 1159 patients (33%) who underwent ATAAD surgery. Thirty-day mortality was 28.9% in patients with preoperative malperfusion and 12.1% in those without. Independent predictors of 30-day mortality included any malperfusion (odds ratio, 2.76; 95% confidence interval [CI], 1.94-3.93), cardiac malperfusion (odds ratio, 2.37; 95% CI, 1.34-4.17), renal malperfusion (odds ratio, 2.38; 95% CI, 1.23-4.61) and peripheral malperfusion (odds ratio, 1.95; 95% CI, 1.26-3.01). Any malperfusion (hazard ratio, 1.72; 95% CI, 1.21-2.43), cardiac malperfusion (hazard ratio, 1.89; 95% CI, 1.24-2.87) and gastrointestinal malperfusion (hazard ratio, 2.25; 95% CI, 1.18-4.26) were predictors of late mortality. Malperfusion was associated with significantly poorer survival at 1, 3, and 5 years (95.0% ± 0.9% vs 88.7% ± 1.9%, 90.1% ± 1.3% vs 84.0% ± 2.4%, and 85.4% ± 1.7% vs 80.8% ± 2.7%; log rank P = .009). Malperfusion has a significant influence on early and late outcomes in ATAAD surgery. Management of preoperative malperfusion remains a major challenge in reducing mortality associated with surgical treatment of ATAAD. University of Iceland Research Fund Landspitali Research Fund Mats Kleberg Foundation Article in Journal/Newspaper Iceland Hirsla - Landspítali University Hospital research archive The Journal of Thoracic and Cardiovascular Surgery 157 4 1324 1333.e6 |