Fausto Biancari, Timo Mäkikallio, Stefano Rosato, Tatu Juvonen, Giovanni Mariscalco, Zein El-Dean, Metesh Acharya, Matteo Pettinari, Javier Rodriguez-Lega, Angel G Pinto, Andrea Perrotti, Francesco Onorati, Konrad Wisniewski, Lenard Conradi, Till Demal, Marek Pol, Jan Rocek, Petr Kacer, Giuseppe Gatti, Igor Vendramin, Daniela Piani, Mauro Rinaldi, Luisa Ferrante, Eduard Quintana, Robert Pruna-Guillen, Sven Peterss, Joscha Buech, Caroline Radner, Mark Field, Amer Harky, Antonio Fiore, Jean Sénémaud, Caius Mustonen, Angelo M Dell'Aquila, Paola D'Errigo, Gianluca Polvani, Dario Di Perna
{"title":"Carotid artery dissection and neurological complications after surgery for type 1 aortic dissection.","authors":"Fausto Biancari, Timo Mäkikallio, Stefano Rosato, Tatu Juvonen, Giovanni Mariscalco, Zein El-Dean, Metesh Acharya, Matteo Pettinari, Javier Rodriguez-Lega, Angel G Pinto, Andrea Perrotti, Francesco Onorati, Konrad Wisniewski, Lenard Conradi, Till Demal, Marek Pol, Jan Rocek, Petr Kacer, Giuseppe Gatti, Igor Vendramin, Daniela Piani, Mauro Rinaldi, Luisa Ferrante, Eduard Quintana, Robert Pruna-Guillen, Sven Peterss, Joscha Buech, Caroline Radner, Mark Field, Amer Harky, Antonio Fiore, Jean Sénémaud, Caius Mustonen, Angelo M Dell'Aquila, Paola D'Errigo, Gianluca Polvani, Dario Di Perna","doi":"10.1136/openhrt-2024-002882","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Data on the prognostic impact of type A aortic dissection involving the common carotid arteries (CCAs) are scarce.</p><p><strong>Methods: </strong>Data on the status of the CCAs were available in 1106 patients who underwent surgery for acute DeBakey type 1 aortic dissection who were recruited in a retrospective, multicentre European registry, that is, the ERTAAD. Postoperative neurological complications were defined as ischaemic stroke, haemorrhagic stroke and/or global brain ischaemia.</p><p><strong>Results: </strong>Patients without carotid artery dissection, those with unilateral or bilateral CCA dissection had in-hospital mortality rates of 19.5%, 16.9% (OR 1.006, 95% CI 0.614 to 1.647) and 27.3% (p<0.001, OR 1.719, 95% CI 1.086 to 2.722), respectively. Bilateral, but not unilateral, dissection of the CCAs increased the risk of neurological complications (40.0% vs 18.9%, OR 2.453, 95% CI 1.683 to 3.576). The negative prognostic effect of bilateral dissection of the CCAs was increased among patients without cerebral malperfusion who underwent surgery with the use of hypothermic circulatory arrest (28.7% vs 4.3%, p=0.014).</p><p><strong>Conclusions: </strong>Bilateral, but not unilateral, dissection of the CCAs may increase the risk of neurological complications and in-hospital mortality after surgery for DeBakey type 1 aortic dissection.</p><p><strong>Trial registration number: </strong>NCT04831073.</p>","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"12 1","pages":""},"PeriodicalIF":2.8000,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907077/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Open Heart","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1136/openhrt-2024-002882","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Data on the prognostic impact of type A aortic dissection involving the common carotid arteries (CCAs) are scarce.
Methods: Data on the status of the CCAs were available in 1106 patients who underwent surgery for acute DeBakey type 1 aortic dissection who were recruited in a retrospective, multicentre European registry, that is, the ERTAAD. Postoperative neurological complications were defined as ischaemic stroke, haemorrhagic stroke and/or global brain ischaemia.
Results: Patients without carotid artery dissection, those with unilateral or bilateral CCA dissection had in-hospital mortality rates of 19.5%, 16.9% (OR 1.006, 95% CI 0.614 to 1.647) and 27.3% (p<0.001, OR 1.719, 95% CI 1.086 to 2.722), respectively. Bilateral, but not unilateral, dissection of the CCAs increased the risk of neurological complications (40.0% vs 18.9%, OR 2.453, 95% CI 1.683 to 3.576). The negative prognostic effect of bilateral dissection of the CCAs was increased among patients without cerebral malperfusion who underwent surgery with the use of hypothermic circulatory arrest (28.7% vs 4.3%, p=0.014).
Conclusions: Bilateral, but not unilateral, dissection of the CCAs may increase the risk of neurological complications and in-hospital mortality after surgery for DeBakey type 1 aortic dissection.
期刊介绍：
Open Heart is an online-only, open access cardiology journal that aims to be “open” in many ways: open access (free access for all readers), open peer review (unblinded peer review) and open data (data sharing is encouraged). The goal is to ensure maximum transparency and maximum impact on research progress and patient care. The journal is dedicated to publishing high quality, peer reviewed medical research in all disciplines and therapeutic areas of cardiovascular medicine. Research is published across all study phases and designs, from study protocols to phase I trials to meta-analyses, including small or specialist studies. Opinionated discussions on controversial topics are welcomed. Open Heart aims to operate a fast submission and review process with continuous publication online, to ensure timely, up-to-date research is available worldwide. The journal adheres to a rigorous and transparent peer review process, and all articles go through a statistical assessment to ensure robustness of the analyses. Open Heart is an official journal of the British Cardiovascular Society.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
