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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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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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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...
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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...
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Updated: Aug 2, 2025

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

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Night-time surgery for type a aortic dissection: Immediate or delaying?

Qian Sichong1,2, Liu Hong3, Wang Shipan1,2

  • 1Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

Perfusion
|April 20, 2023
PubMed
Summary

Night-time surgery for type A aortic dissection (TAAD) is linked to higher operative mortality. However, emergency night-time repair remains a critical option for patients with TAAD, offering acceptable outcomes despite increased risks.

Keywords:
emergency surgerynight-time surgeryoperative mortalitytotal-arch replacementtype A aortic dissection

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Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Aortic Disease Research

Background:

  • Type A aortic dissection (TAAD) is a life-threatening condition requiring prompt surgical intervention.
  • The timing of surgery, specifically night-time versus day-time, may influence patient outcomes in complex cardiovascular procedures.

Purpose of the Study:

  • To investigate the association between night-time versus day-time surgery and operative mortality in patients with type A aortic dissection (TAAD).
  • To identify risk factors contributing to operative mortality in TAAD patients undergoing surgical repair.

Main Methods:

  • Retrospective analysis of 2015 TAAD patients who underwent surgical repair between January 2015 and January 2021.
  • Patients were categorized into two groups based on surgery start time: day-time (06:01 a.m. to 06:00 p.m.) and night-time (06:01 p.m. to 06:00 a.m.).
  • Comparative analysis of operative mortality, 30-day mortality, in-hospital mortality, ICU stay, and ventilation support duration between the two groups.

Main Results:

  • Night-time surgery was associated with significantly higher operative mortality (12.2%) compared to day-time surgery (6.9%; p = 0.001).
  • The night-time group experienced higher 30-day mortality (10.8% vs 5.8%; p = 0.001) and in-hospital mortality (6.0% vs 3.5%; p = 0.03).
  • Independent risk factors for operative mortality included night-time surgery (OR, 1.545), advanced age, total arch replacement, and prior aortic surgery.

Conclusions:

  • Night-time surgical repair for TAAD may be linked to increased operative mortality.
  • Despite the increased risk, emergency night-time surgery is often necessary for TAAD patients to prevent catastrophic complications.
  • Outcomes suggest that operative mortality for night-time TAAD surgery, while higher, remains within an acceptable range, underscoring the importance of timely intervention.