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- Title
Delayed surgery for acute type A aortic dissection: a retrospective review of an alternative surgical strategy in the COVID-19 era.
- Authors
Itokawa, Rin; Kowatari, Ryosuke; Imamura, Yuki; Sasaki, Hanae; Kondo, Norihiro; Daitoku, Kazuyuki; Minakawa, Masahito
- Abstract
Background: During the coronavirus disease (COVID-19) pandemic, medical resources have often been limited to emergency surgeries. This study aimed to evaluate our experience with delayed surgery for acute type A aortic dissections (ATAADs). Methods: A retrospective study was conducted on 33 patients who underwent surgery for ATAADs between January 2020 and December 2021. The patients were divided into two groups: patients treated within 12 h of arrival (E group; N = 21) and those treated > 12 h after arrival (D group; N = 12) with strict antihypertensive therapy until surgery. Results: The plasma fibrinogen levels on arrival were lower in the D group than in the E group (174.3 ± 109.1 vs 293.4 ± 165.4, p = 0.038). The time to surgery from symptom onset was longer in the D group than in the E group (4 ± 1 h vs. 86 ± 108 h, p < 0.001). There was one case (3%) of mortality and seven cases (21%) of cerebral infarctions in the E group. There was no significant difference in the intraoperative data and quantity of blood transfused between the two groups. Conclusion: Thus, delayed surgery for ATAAD with appropriate preoperative management may be an alternative surgical strategy in the COVID-19 era.
- Subjects
COVID-19 pandemic; AORTIC dissection; DISSECTION; COVID-19; SURGICAL emergencies; CEREBRAL infarction
- Publication
Journal of Cardiothoracic Surgery, 2024, Vol 19, Issue 1, p1
- ISSN
1749-8090
- Publication type
Article
- DOI
10.1186/s13019-024-02682-2