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Related Concept Videos

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Aneurysm IV: Nursing Management

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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...
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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...
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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...
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Related Experiment Video

Updated: Oct 10, 2025

Porcine Model of Infrarenal Abdominal Aortic Aneurysm
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Postoperative Hepatic Dysfunction After Frozen Elephant Trunk for Type A Aortic Dissection.

Shenghua Liang1, Yanxiang Liu1, Bowen Zhang1

  • 1Department of Cardiovascular Surgery, The National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and the Peking Union Medical College, Beijing, China.

Frontiers in Cardiovascular Medicine
|December 9, 2021
PubMed
Summary

Postoperative hepatic dysfunction (PHD) after frozen elephant trunk repair for type A aortic dissection increases early mortality and morbidity. Key predictors include elevated aspartate transferase, celiac malperfusion, and longer bypass times.

Keywords:
aortic dissectionfrozen elephant trunkhepatic dysfunctionmalperfusionrisk factors

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Area of Science:

  • Cardiovascular Surgery
  • Hepatology
  • Thoracic Surgery

Background:

  • Type A aortic dissection (TAAD) repair using the frozen elephant trunk (FET) technique is complex.
  • Postoperative hepatic dysfunction (PHD) is a potential complication following major aortic surgery.
  • Understanding PHD incidence, risk factors, and outcomes is crucial for patient management.

Purpose of the Study:

  • To investigate the incidence of PHD in patients undergoing FET for TAAD.
  • To identify independent risk factors associated with PHD development.
  • To evaluate the impact of PHD on early and midterm patient outcomes.

Main Methods:

  • Retrospective analysis of 492 patients who underwent FET for TAAD (2015-2019).
  • Multivariate mixed-effect logistic regression used to determine independent risk factors for PHD.
  • Surgeon-specific factors were included as random effects in the analysis.

Main Results:

  • The incidence of PHD was 25.4%.
  • PHD patients had significantly higher early mortality (10.4% vs 1.1%), acute kidney injury (42.4% vs 12.8%), and need for dialysis (23.2% vs 3.0%).
  • Predictors for PHD included preoperative aspartate transferase, celiac trunk malperfusion, and cardiopulmonary bypass time; retrograde perfusion reduced risk.

Conclusions:

  • PHD significantly increases early mortality and morbidity after FET for TAAD.
  • While associated with worse short-term outcomes, PHD did not impact midterm survival after excluding early deaths.
  • Preoperative aspartate transferase, celiac trunk malperfusion, and CPB duration are key predictors of PHD.