Document Detail

Predictors and outcomes associated with intraoperative aortic dissection in cardiac surgery.
MedLine Citation:
PMID:  18564295     Owner:  NLM     Status:  MEDLINE    
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.
Amber Hurt; J Michael Smith; Amy M Engel
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Publication Detail:
Type:  Journal Article     Date:  2008-06-18
Journal Detail:
Title:  Journal of cardiac surgery     Volume:  23     ISSN:  1540-8191     ISO Abbreviation:  J Card Surg     Publication Date:    2008 Sep-Oct
Date Detail:
Created Date:  2008-10-20     Completed Date:  2009-03-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8908809     Medline TA:  J Card Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  422-5     Citation Subset:  IM    
Department of Surgery, Good Samaritan Hospital, Cincinnati, Ohio 45220, USA.
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MeSH Terms
Aged, 80 and over
Aneurysm, Dissecting / etiology*,  mortality
Aortic Aneurysm / etiology*,  mortality
Cardiovascular Surgical Procedures / adverse effects*,  mortality
Case-Control Studies
Cohort Studies
Confounding Factors (Epidemiology)
Health Status Indicators
Middle Aged
Perioperative Care*
Prospective Studies
Risk Factors
Thoracic Surgery*
Treatment Outcome

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

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