Effect of atherothrombotic aorta on outcomes of total aortic arch replacement

The Journal of Thoracic and Cardiovascular Surgery
Kenji OkadaYutaka Okita

Abstract

The effect of an atherothrombotic aorta on the short- and long-term outcomes of total aortic arch replacement, including postoperative neurologic deficits, remains unknown. We evaluated this relationship and also elucidated the synergistic effect of multiple other risk factors, in addition to an atherothrombotic aorta, on the neurologic outcome. A group of 179 consecutive patients undergoing total aortic arch replacement were studied. An atherothrombotic aorta was present in 34 patients (19%), more than moderate leukoaraiosis in 71 (39.7%), and significant extracranial carotid artery stenosis in 27 (15.1%). In-hospital deaths occurred in 2 patients, 1 (2.9%) of 34 patients with and 1 (0.7%) of 145 patients without an atherothrombotic aorta (P = .26). Permanent neurologic deficits occurred in 4 (2.2%) and transient neurologic deficits in 17 (9.5%) patients. Multivariate analysis demonstrated that the risk factors for transient neurologic deficits were an atherothrombotic aorta (odds ratio, 4.4), extracranial carotid artery stenosis (odds ratio, 5.5), moderate/severe leukoaraiosis (odds ratio, 3.6), and cardiopulmonary bypass time (odds ratio, 1.02). To calculate the probability of transient neurologic deficits, the following equ...Continue Reading

References

Aug 15, 1991·The New England Journal of Medicine·UNKNOWN North American Symptomatic Carotid Endarterectomy Trial CollaboratorsM Eliasziw
Sep 1, 1991·Annals of Vascular Surgery·L H HollierC D Procter
Oct 2, 1986·The New England Journal of Medicine·B R Chambers, J W Norris
Dec 1, 1994·The New England Journal of Medicine·P AmarencoM G Bousser
Dec 31, 1998·The Journal of Thoracic and Cardiovascular Surgery·D L ReichR B Griepp
Jul 3, 1999·The Annals of Thoracic Surgery·J BachetC Dubois
Oct 8, 2003·The Annals of Thoracic Surgery·Tatjana M FleckMartin Grabenwoger
Jan 30, 2007·The Annals of Thoracic Surgery·Teruhisa KazuiTakayasu Suzuki
Mar 27, 2007·The Journal of Thoracic and Cardiovascular Surgery·Ridwan LinDerk Krieger
May 13, 2008·General Thoracic and Cardiovascular Surgery·Masahito MinakawaHiroshi Hashimoto
Sep 23, 2008·The Journal of Thoracic and Cardiovascular Surgery·Hitoshi OginoSoichiro Kitamura
Jan 29, 2011·The Journal of Thoracic and Cardiovascular Surgery·Hazim J SafiAnthony L Estrera

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Citations

Feb 14, 2013·General Thoracic and Cardiovascular Surgery·Ikuo FukudaWakako Fukuda
Mar 4, 2014·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Hiroshi KurazumiKimikazu Hamano
Apr 1, 2014·Journal of Vascular Surgery·Arudo HiraokaHidenori Yoshitaka
Oct 8, 2014·General Thoracic and Cardiovascular Surgery·Yutaka Okita
Jun 20, 2019·Asian Cardiovascular & Thoracic Annals·Hiroshi KurazumiShigeru Ikenaga
Feb 6, 2017·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Shunsuke MiyaharaUNKNOWN Japan Cardiovascular Surgery Database Organization
Jul 25, 2019·Surgery Today·Yoshiyuki TokudaAkihiko Usui
Jan 19, 2019·The Journal of Thoracic and Cardiovascular Surgery·Yuki IkenoYutaka Okita
Nov 4, 2020·Heart, Lung & Circulation·Masato MutsugaAkihiko Usui

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