Operative outcomes of aTAAD patients with antiplatelet agents misdiagnosed as ACS
10.3760/cma.j.issn.1001-4497.2017.07.009
- VernacularTitle:误诊急性冠状动脉综合征的急性Stanford A型主动脉夹层术前口服抗血小板药物对手术转归的影响
- Author:
Yunxing XUE
;
Qing ZHOU
;
Xiyu ZHU
;
Dongjin WANG
- Keywords:
Aortic dissection;
Aortic diseases;
Anti-platelet therapy
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2017;33(7):417-419
- CountryChina
- Language:Chinese
-
Abstract:
Objective Acute Stanford type A aortic dissection(aTAAD) is often misdiagnosed as acute coronary syndrome(ACS), anti-platelet therapy for ACS will influence the timing and outcome of aTAAD.We reviewed the surgical outcome of these misdiagnosed aTAAD patients.Methods From January 2011 to October 2015, 309 aTAAD patients have received surgical therapy in our department, among them 15 patients had misdiagnosed as ACS and taken oral anti-platelet therapy, 9 male and 6 female, the average age was(60.6±8.7) years.Retrospectively reviewed the data of perioperative and follow-up period.Results 5 patients took orally aspirin, 10 took aspirin and clopidogrel.2 patients had received operation 7 days after stopping the agents, 3 days for 3 patients, 1 day for 1 patient, and the other 5 patients received emergency operation without stopping the agents.The cardiopulmonary bypass time was(259.7±64.8) minutes, aortic cross-clamp time was(181.0±51.7) minutes, and selective cerebral perfusion and lower body arrest time was(34.9±8.1) minutes.There were 2 in-hospital deaths due to circulation failure(mortality 13.3%).The average drainage volume in the first 24 hours after operation was(800.7±598.8)ml.During a mean follow-up period of(20.6±17.4) months, one patient had suddenly death.Conclusion aTAAD misdiagnosed as ACS was not rare, anti-platelet therapy will increase the risk of bleeding.The decision of operation time rely on considering balance between the rupture risk of aortic dissection and the hemorrhage risk of anti-platelet therapy.Emergency operation for these patients will increase the bleeding and transfusion.
