Related Experiment Video

Updated: Oct 16, 2025

Novel and Innovative Hybrid Technique for Type A Aortic Dissection
06:26

Novel and Innovative Hybrid Technique for Type A Aortic Dissection

Published on: March 28, 2025

535

Outcomes of preoperative antiplatelet therapy in patients with acute type A aortic dissection

Xuan Jiang1, Fareed Khan1, Enyi Shi1

  • 1Department of Cardiac Surgery, First Affiliated Hospital, China Medical University, Shenyang, China.

Journal of Cardiac Surgery
|October 17, 2021
PubMed

Insights

Antiplatelet therapy before acute type A aortic dissection repair is linked to increased transfusions and higher mortality. Careful surgical timing is crucial for patient outcomes.

Area of Science:

  • Cardiovascular Surgery
  • Vascular Surgery
  • Thoracic Surgery

Background:

  • Acute type A aortic dissection (ATAAD) is a life-threatening condition requiring immediate surgical intervention.
  • Patients may be misdiagnosed with acute coronary syndrome, leading to antiplatelet therapy (APT) before ATAAD diagnosis.
  • The impact of preoperative APT on clinical outcomes in ATAAD patients is not well-established.

Purpose of the Study:

  • To investigate the association between preoperative antiplatelet therapy (APT) and clinical outcomes in patients undergoing surgery for acute type A aortic dissection (ATAAD).
  • To compare complication rates and mortality between ATAAD patients who received APT and those who did not.

Main Methods:

  • Retrospective analysis of the Chinese Acute Aortic Syndrome (AAS) Collaboration Database.
  • Propensity score matching (PSM) was used to balance baseline characteristics between APT and non-APT groups.
  • Logistic regression analysis was employed to compare outcomes, including complications and mortality.

Main Results:

  • After PSM, 30 patients were in the APT group and 80 in the non-APT group.
  • The APT group showed significantly higher rates of blood product transfusions (packed red blood cells, plasma, platelets) and greater chest drainage volume.
  • Mortality was significantly higher in the APT group (26% vs. 10%, p=0.027), with preoperative APT being an independent predictor of mortality (OR: 6.808, p=0.011).

Conclusions:

  • Preoperative antiplatelet therapy in ATAAD patients is associated with increased transfusion requirements and higher early mortality.
  • These findings underscore the importance of carefully considering the timing of surgery in relation to APT use.
  • Surgeon experience and patient-specific factors should guide surgical decision-making in ATAAD patients on APT.
Abstract

Keywords:
anticoagulationantiplatelet therapyaortic dissectionaortic surgerydeep hypothermic circulatory arrest

More Related Videos

A New Murine Model of Endovascular Aortic Aneurysm Repair08:51

A New Murine Model of Endovascular Aortic Aneurysm Repair

Published on: July 7, 2013

14.5K
Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement08:50

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement

Published on: March 26, 2018

11.9K

Related Concept Videos

Aneurysm IV: Nursing Management01:22

Aneurysm IV: Nursing Management

Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
39
Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors01:20

Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors

Antiplatelet drugs emerge as frontline defenders against the insidious threat of thromboembolic diseases, where abnormal clots obstruct vital blood vessels. These drugs stand as bulwarks, inhibiting platelet aggregation and clot formation, thereby mitigating the risk of life-threatening conditions like myocardial infarction, coronary artery disease, and thrombotic strokes.
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
750
Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
54
Peripheral Artery Disease V: Postoperative Nursing Management01:23

Peripheral Artery Disease V: Postoperative Nursing Management

During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
57
Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
70
Aortic Regurgitation I: Introduction01:15

Aortic Regurgitation I: Introduction

IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
72