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Risk factors of cerebral complications after Stanford type A aortic dissection undergoing arch surgery

Yanyan Song1, Li Liu1, Bo Jiang1

  • 1Department of Cardiovascular Surgery, General Hospital of Ningxia Medical University, Yinchuan, China.

Asian Journal of Surgery
|August 11, 2021
PubMed

Insights

Deep hypothermic circulatory arrest time, blood product transfusion volume, stroke history, and carotid plaque are key risk factors for neurological complications after Stanford type A aortic arch surgery.

Area of Science:

  • Cardiovascular Surgery
  • Neurology
  • Vascular Surgery

Background:

  • Stanford type A aortic dissection requires complex surgical repair.
  • Cerebral neurological complications are a significant concern following this procedure.

Purpose of the Study:

  • To identify risk factors for postoperative cerebral neurological complications in patients undergoing Stanford type A aortic arch surgery.

Main Methods:

  • A cohort of 116 patients undergoing Stanford type A aortic dissection repair between 2012 and 2019 were analyzed.
  • Patients were grouped based on the presence and severity of postoperative neurological complications.
  • Statistical analysis included single-factor and multi-factor logistic regression to determine predictive factors.

Main Results:

  • Cerebral neurological complications occurred in 26.72% of patients (31/116).
  • Independent predictive factors identified were: deep hypothermic circulatory arrest (DHCA) time >40 minutes, plasma transfusion >800 ml, erythrocyte suspension transfusion >6 U, history of stroke, and presence of carotid plaque or stenosis.

Conclusions:

  • DHCA duration, significant blood product transfusion, pre-existing stroke history, and carotid artery disease are independent predictors of neurological complications.
  • Targeted interventions for patients with these risk factors may help mitigate neurological deficits.
Abstract

Keywords:
Aortic arch surgeryNeurological complicationsNeurological dysfunctionRisk factorsStanford type A aortic dissection

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