Presentation
Incidence, etiology and classification of neurologic injury associated with surgical intervention for acute Type A Aortic Dissection
Canadian Undergraduate Conference on Healthcare
(2016)
Abstract
Aortic operations have generally been associated with significant rates of mortality. Neurologic injury is particularly prevalent in those involving the aortic arch due to the complex anatomic challenges. Advances in surgical technique and perioperative patient care have greatly improved patient outcomes in cardiac surgery. However, there remains a significantly high incidence of mortality (10-20%) and neurologic injury (10-30%), generally in the form of a stroke, following repairs of Acute Type A Aortic Dissection (ATAAD). This study is a retrospective analysis of emergent operations for ATAAD in adults (>18 years of age) between 2005 and 2016 by the Division of Cardiac Surgery at the Foothills Medical Centre (Calgary, AB). Understanding the incidence of pre- and post-operative neurological injury in patients undergoing surgery for ATAAD and classifying the specific neurovascular patterns of the patients who suffer a stroke allows for more effective management of patients by surgeons. Patients undergoing ATAAD repair with deep hypothermic circulatory arrest (DHCA) are found to have similar outcomes as those undergoing repair with selective antegrade cerebral protection (sACP). However, patients undergoing ATAAD repair with DHCA and retrograde cerebral protection (RCP) have a significantly (p < 0.05) higher post-operative cerebrovascular accident rate than patients who do not. Similar results can be found when controlling for prolonged cross-clamp and cardiopulmonary bypass times.
Disciplines
Publication Date
November 20, 2016
Location
Queen's University, Kingston, ON
Citation Information
Alexander Puddifant. "Incidence, etiology and classification of neurologic injury associated with surgical intervention for acute Type A Aortic Dissection" Canadian Undergraduate Conference on Healthcare (2016) Available at: http://works.bepress.com/alexander-puddifant/1/