Document Detail


Multivariate analysis of predictors of late stroke after total aortic arch repair.
MedLine Citation:
PMID:  15979882     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The number of aortic surgeries has recently increased, with improvement of outcome due to the development of various novel operative techniques and adjuncts. Although the postoperative incidence of stroke, the most severe complication of aortic surgery, is still a matter of concern and has been described well previously, late stroke after aortic arch repair has not been described well. We assessed the incidence and predictors of late stroke after total aortic arch repair. METHODS: From January 1993 to December 2003, 470 patients underwent total aortic arch repair in our institution. All patients, whether undergoing elective, urgent, or emergent aortic arch repair, were included. Emergent operation was required for 115 patients because of rupture or acute type A dissection. For brain protection, retrograde cerebral perfusion was used in 27% (125) and selective cerebral perfusion in 75% (353) of cases. The follow-up period was 32.5+/-31.5 months. Late stroke was defined as stroke occurring more than 30 days postoperatively. RESULTS: The incidence of early postoperative stroke was 4.9% (23/470), while that of late postoperative stroke was 6.0% (28/470). On univariate analysis, postoperative atrial fibrillation (P=0.014), preoperative prevalence of craniocervical lesions (P=0.0001), and advanced age (P=0.046) were each significantly related to late stroke. A Cox proportional hazards model detected postoperative atrial fibrillation (P=0.013, OR=3.02, 95% CI: 1.26-7.24) and preoperative prevalence of craniocervical lesions (P=0.0001, OR=5.37, 95% CI: 2.30-12.52) as predictors of late stroke. CONCLUSIONS: Postoperative atrial fibrillation and preoperative prevalence of craniocervical lesions were found to be risk factors for late stroke after total aortic arch repair.
Authors:
Kaoru Matsuura; Hitoshi Ogino; Hitoshi Matsuda; Kenji Minatoya; Hiroaki Sasaki; Toshikatsu Yagihara; Soichiro Kitamura
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  28     ISSN:  1010-7940     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  2005 Sep 
Date Detail:
Created Date:  2005-08-22     Completed Date:  2006-02-21     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  473-7     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Surgery, National Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka 565-8565, Japan.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Age Factors
Aged
Aneurysm, Dissecting / surgery*
Aorta, Thoracic / surgery*
Aortic Aneurysm / surgery*
Aortic Rupture / surgery
Atrial Fibrillation / complications
Cerebrovascular Disorders / complications
Female
Follow-Up Studies
Humans
Male
Middle Aged
Multivariate Analysis
Proportional Hazards Models
Risk Factors
Stroke / etiology*
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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