Cargando…

Perioperative Mass Transfusion Affects In-Hospital but Not Follow-Up Survival in Patients with Acute Type A Aortic Dissection

Background and Objectives: The aim of this study was to analyze the influence of mass transfusion on the postoperative outcome and survival in patients presenting with acute Type A aortic dissection. Materials and Methods: Between 2002 and 2020, a total of 505 patients were surgically treated for an...

Descripción completa

Detalles Bibliográficos
Autores principales: Benk, Julia, Berger, Tim, Gottardi, Roman, Walter, Tim, Kondov, Stoyan, Rylski, Bartosz, Czerny, Martin, Kreibich, Maximilian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10608168/
https://www.ncbi.nlm.nih.gov/pubmed/37893543
http://dx.doi.org/10.3390/medicina59101825
_version_ 1785127716686659584
author Benk, Julia
Berger, Tim
Gottardi, Roman
Walter, Tim
Kondov, Stoyan
Rylski, Bartosz
Czerny, Martin
Kreibich, Maximilian
author_facet Benk, Julia
Berger, Tim
Gottardi, Roman
Walter, Tim
Kondov, Stoyan
Rylski, Bartosz
Czerny, Martin
Kreibich, Maximilian
author_sort Benk, Julia
collection PubMed
description Background and Objectives: The aim of this study was to analyze the influence of mass transfusion on the postoperative outcome and survival in patients presenting with acute Type A aortic dissection. Materials and Methods: Between 2002 and 2020, a total of 505 patients were surgically treated for an acute Type A aortic dissection. Mass transfusion was defined as the peri- and postoperative replacement by transfusion of 10 units. Patient characteristics and outcomes were analyzed and compared between patients with and without mass transfusion. Results: Mass transfusion occurred in 105 patients (20%). The incidences of symptomatic coronary malperfusion (p = 0.017) and tamponade (p = 0.043) were higher in patients with mass transfusion. There was no statistically significant difference in the distal extension of the aortic dissection between the two groups. A valved conduit was significantly more common in patients with mass transfusion (p = 0.007), while the distal aortic repair was similar between the two groups. Cardiopulmonary bypass time (p < 0.001), cross clamp time (p < 0.001) and in-hospital mortality were significantly higher in patients with mass transfusion (p < 0.001), but the survival after discharge (landmark-analysis) showed equal survival between patients with and without mass transfusion (log rank: p = 0.4). Mass transfusion was predictive of in-hospital mortality (OR: 3.308, p < 0.001) but not for survival after discharge (OR: 1.205, p = 0.661). Conclusions: Mass transfusion is necessary in many patients with acute Type A aortic dissection. These patients present sicker and require longer surgery. However, mass transfusion does not influence survival after discharge.
format Online
Article
Text
id pubmed-10608168
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-106081682023-10-28 Perioperative Mass Transfusion Affects In-Hospital but Not Follow-Up Survival in Patients with Acute Type A Aortic Dissection Benk, Julia Berger, Tim Gottardi, Roman Walter, Tim Kondov, Stoyan Rylski, Bartosz Czerny, Martin Kreibich, Maximilian Medicina (Kaunas) Article Background and Objectives: The aim of this study was to analyze the influence of mass transfusion on the postoperative outcome and survival in patients presenting with acute Type A aortic dissection. Materials and Methods: Between 2002 and 2020, a total of 505 patients were surgically treated for an acute Type A aortic dissection. Mass transfusion was defined as the peri- and postoperative replacement by transfusion of 10 units. Patient characteristics and outcomes were analyzed and compared between patients with and without mass transfusion. Results: Mass transfusion occurred in 105 patients (20%). The incidences of symptomatic coronary malperfusion (p = 0.017) and tamponade (p = 0.043) were higher in patients with mass transfusion. There was no statistically significant difference in the distal extension of the aortic dissection between the two groups. A valved conduit was significantly more common in patients with mass transfusion (p = 0.007), while the distal aortic repair was similar between the two groups. Cardiopulmonary bypass time (p < 0.001), cross clamp time (p < 0.001) and in-hospital mortality were significantly higher in patients with mass transfusion (p < 0.001), but the survival after discharge (landmark-analysis) showed equal survival between patients with and without mass transfusion (log rank: p = 0.4). Mass transfusion was predictive of in-hospital mortality (OR: 3.308, p < 0.001) but not for survival after discharge (OR: 1.205, p = 0.661). Conclusions: Mass transfusion is necessary in many patients with acute Type A aortic dissection. These patients present sicker and require longer surgery. However, mass transfusion does not influence survival after discharge. MDPI 2023-10-13 /pmc/articles/PMC10608168/ /pubmed/37893543 http://dx.doi.org/10.3390/medicina59101825 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Benk, Julia
Berger, Tim
Gottardi, Roman
Walter, Tim
Kondov, Stoyan
Rylski, Bartosz
Czerny, Martin
Kreibich, Maximilian
Perioperative Mass Transfusion Affects In-Hospital but Not Follow-Up Survival in Patients with Acute Type A Aortic Dissection
title Perioperative Mass Transfusion Affects In-Hospital but Not Follow-Up Survival in Patients with Acute Type A Aortic Dissection
title_full Perioperative Mass Transfusion Affects In-Hospital but Not Follow-Up Survival in Patients with Acute Type A Aortic Dissection
title_fullStr Perioperative Mass Transfusion Affects In-Hospital but Not Follow-Up Survival in Patients with Acute Type A Aortic Dissection
title_full_unstemmed Perioperative Mass Transfusion Affects In-Hospital but Not Follow-Up Survival in Patients with Acute Type A Aortic Dissection
title_short Perioperative Mass Transfusion Affects In-Hospital but Not Follow-Up Survival in Patients with Acute Type A Aortic Dissection
title_sort perioperative mass transfusion affects in-hospital but not follow-up survival in patients with acute type a aortic dissection
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10608168/
https://www.ncbi.nlm.nih.gov/pubmed/37893543
http://dx.doi.org/10.3390/medicina59101825
work_keys_str_mv AT benkjulia perioperativemasstransfusionaffectsinhospitalbutnotfollowupsurvivalinpatientswithacutetypeaaorticdissection
AT bergertim perioperativemasstransfusionaffectsinhospitalbutnotfollowupsurvivalinpatientswithacutetypeaaorticdissection
AT gottardiroman perioperativemasstransfusionaffectsinhospitalbutnotfollowupsurvivalinpatientswithacutetypeaaorticdissection
AT waltertim perioperativemasstransfusionaffectsinhospitalbutnotfollowupsurvivalinpatientswithacutetypeaaorticdissection
AT kondovstoyan perioperativemasstransfusionaffectsinhospitalbutnotfollowupsurvivalinpatientswithacutetypeaaorticdissection
AT rylskibartosz perioperativemasstransfusionaffectsinhospitalbutnotfollowupsurvivalinpatientswithacutetypeaaorticdissection
AT czernymartin perioperativemasstransfusionaffectsinhospitalbutnotfollowupsurvivalinpatientswithacutetypeaaorticdissection
AT kreibichmaximilian perioperativemasstransfusionaffectsinhospitalbutnotfollowupsurvivalinpatientswithacutetypeaaorticdissection