Gastrointestinal bleeding risk factors in type A aortic dissection post-aortic arch replacement

Area of Science:

• Cardiovascular Surgery
• Gastroenterology
• Critical Care Medicine

Background:

• Gastrointestinal bleeding (GIB) is a serious complication in patients with aortic dissection (AD).
• Understanding GIB in AD patients is crucial for improving surgical outcomes.

Purpose of the Study:

• To evaluate outcomes associated with GIB in AD patients.
• To identify independent risk factors for GIB in AD patients undergoing total aortic arch replacement (TAAR).

Main Methods:

• Retrospective case-control study of 198 patients with type A aortic dissection (TAAD) who underwent TAAR.
• Analysis of clinical data, laboratory findings, and imaging to identify GIB risk factors.

Main Results:

• 19.2% of patients developed postoperative GIB, with significantly higher mortality and prolonged ICU stays and ventilation durations.
• Independent risk factors for GIB included age >54 years, intraoperative RBC transfusion >600 mL, and concomitant celiac and SMA hypoperfusion.

Conclusions:

• GIB following TAAR in AD patients is associated with adverse prognosis.
• Advanced age, extensive intraoperative transfusion, and GI perfusion abnormalities are significant risk factors for GIB.