Research Of Clinical Characteristics And Early Adverse Events After Surgery In Patients With Stanford A Aortic Dissection

Objective:The aim of this study was to summarize the clinical characteristics of the patients with Stanford A aortic dissection,and analysis the risk factors of early adverse events after surgery.Methods:In this study we retrospectively collect and sum up the clinical characteristics of the patients with Stanford A aortic dissection,who were cured in Department of Cardiac Surgery,Cardiac Intensive Care Unit(CICU)and other intensive care unit of Lanzhou University Second hospital.The date be collected including age,gender,BMI,past medical history,time of onset,the initial clinical manifestation,the comorbidity of cardiovascular system,surgical methods and so on.According to whether there was an adverse event after the sugical operation,all the patients were divided into two groups,one was A-Group(adverse event group),and the other one was B-Group.Analysis the risk factors of adverse events after the sugical operation.Results:1.There were 76 patients be collected in this study,among them 52 patients were males(68.42%),the rest 24 patients were females(31.58%),the male to female ratio was 2.17:1.The age of the 76 patients ranged from 25~70 years,the average age was 50.26±10.08 years.From March to May,and September to December,the incidence rate of the Stanford A aortic dissection were both higher and concentrated than any other months.2.Among the 76 patients,45 patients suffered from hypertension(59.21%),5 patients had Marfan syndrome(6.58%),3 patients had Bicuspid aortic valve(3.95%),28 patients had aortic valve regurgitation(36.84%),23 patients had mitral regurgitation(30.26%),25 patients had tricuspid regurgitation(32.89%),21 patients had pericardial effusion(27.63%).3.Compared with the B-Group,more patients of A-Group had hypertension more than 5 years,the systolic pressure of them was higher and more patients had higher BMI(≥28kg/m~2).More patients had pericardial effusion,renal insufficiency and longer CPB time,the differences were statistically significant between the two groups.Conclusion:1.The incidence rate of Stanford A aortic dissection is higher in males than in females,the average age of the patients with Stanford A aortic dissection in China is significantly younger than that of the patients in foreign patients.,the reason is still unclear,we speculate that it might be associated with poor health awareness,the difference in health care level and the difference in race.2.The incidence of Stanford A aortic dissection is related to temperature and season.The incidence rate is higher when the temperature lower and the season changes.we speculate that the condition of the patients might get worse when the temperature and season change rapidly.However,the internal connection between them need a multidisciplinary research.3.Stanford A aortic dissection is a critical disease,early diagnosis and treatment can prevent death,we should take personalized sugical methods so as to obtain better clinical results.4.Theindependentriskfactorsofadverseeventsincludemorethan5years’hypertension,the higher systolic pressure,higher BMI(≥28kg/m~2),pericardial effusion before surgery,renal insufficiency and longer CPB time.We should take care of these independent risk factors of adverse events,and take necessary measures to avoid them.