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S Leontyev, J Légaré, MA Borger, K Buth, AK Funkat, J Gerhard, S Lehmann, J Seeburger, FW Mohr

PREDICTORS FOR IN HOSPITAL MORTALITY IN PATIENTS WITH TYPE A AORTIC DISSECTION FROM A TWO CENTRE EXPERIENCE. S Leontyev, J Légaré, MA Borger, K Buth, AK Funkat, J Gerhard, S Lehmann, J Seeburger, FW Mohr. Department of Cardiac Surgery, Heart Center, University of Leipzig, Germany.

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S Leontyev, J Légaré, MA Borger, K Buth, AK Funkat, J Gerhard, S Lehmann, J Seeburger, FW Mohr

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  1. PREDICTORS FOR IN HOSPITAL MORTALITY IN PATIENTS WITH TYPE A AORTIC DISSECTION FROM A TWO CENTRE EXPERIENCE S Leontyev, J Légaré, MA Borger, K Buth, AK Funkat, J Gerhard, S Lehmann, J Seeburger, FW Mohr Department of Cardiac Surgery, Heart Center, University of Leipzig, Germany. Department of Cardiac Surgery, Heart Center, University of Leipzig, Germany.

  2. Background Acute type A aortic dissection a cardiovascular emergency with a high potential for death. worldwide prevalence 0.5 to 2.95 per 100,000 per year; the prevalence ranges from 0.2 to 0.8 per 100,000 per year in the U.S. - 2000 new cases per year (1). Surgical mortality rates 9% to 36% (2,3) 3-year survival - 86%(4) and5-year survival to 50-80%(3). 1Cohn et all 2007 2 Trimarchi et all 2005; 3 Thiappini et all 2005 4 Tsai et all 2006

  3. Aim / Methods Analysis of all patients (n=465)undergoing aortic surgery for acute Type A dissection in Leipzig (Germany)(n=374) and Halifax (Canada) (n=91) over the same period between 1996 and 2010. To evaluate predictors for in hospital mortality after surgical treatment in patients with type A aortic dissection

  4. Demographics

  5. Preoperative state

  6. Preoperative malperfision

  7. Operative data

  8. Operation

  9. Multivariate analysisall patients( Preoperative risk factors) Critical preoperative state - preoperative ventilation, inotropic support, cardiopulmonary resuscitation and unstable preoperative status

  10. Mortality

  11. Mortality 107 patients died during first 30 days • The reasons of death • low cardiac output 50.5% • neurological complication 13.7% • multi-organ failure 7.5% • aortic rupture 5.3% • other 20%

  12. Conclusion • This represents one of the largest series of patients with Type A aortic dissection in which a risk model could be created • The surgical treatment of patients with acute aortic Type A Dissection is associated with high operative mortality. • We identified the following independent predictors of poor outcome: • The critical preoperative state • The presence of malperfusion

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