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Does malperfusion syndrome affect early and mid-term outcome in patients suffering from acute type A aortic

Franz F Immer1, Véronique Grobéty, Alexander Lauten

  • 1Department of Cardiovascular Surgery, University Hospital, 3010 Berne, Switzerland. franzimmer@yahoo.de

Interactive Cardiovascular and Thoracic Surgery
|August 3, 2007
PubMed

Insights

Malperfusion syndrome (MPS) significantly increases mortality for acute type A aortic dissection (AADA) patients. Survivors with MPS face poorer outcomes and lower quality of life, especially those with central nervous system involvement.

Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Aortic Disease

Background:

  • Malperfusion syndrome (MPS) is a known complication of acute type A aortic dissection (AADA).
  • MPS is associated with increased early mortality in AADA patients.
  • Outcomes for AADA patients who survive surgery, with or without MPS, require further analysis.

Purpose of the Study:

  • To evaluate the in-hospital outcomes, late mortality, and quality of life (QoL) of AADA patients who underwent surgical treatment.
  • To specifically analyze the impact of preoperative malperfusion syndrome (MPS) on these outcomes.

Main Methods:

  • Retrospective analysis of 227 consecutive patients undergoing surgery for AADA.
  • Comparison of outcomes between patients with and without preoperative MPS.
  • Assessment of in-hospital mortality, 3-year survival rates, and QoL using the SF-36 questionnaire.

Main Results:

  • 33% of AADA patients presented with preoperative MPS.
  • In-hospital mortality was higher in the MPS group (18.7%) compared to the non-MPS group (9.9%).
  • 3-year survival was significantly lower for MPS patients (73.3%) versus non-MPS patients (86.2%).
  • QoL was generally lower in MPS patients, particularly those with central nervous system (CNS) involvement (SF-36: 65.8).

Conclusions:

  • AADA associated with MPS carries a higher early and mid-term mortality risk.
  • Postoperative mid-term QoL is generally good for AADA survivors without MPS.
  • QoL is significantly impacted in AADA patients with CNS-MPS and persistent neurological deficits.

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