Experience for 107 patients with acute type A aortic dissection involving coronary arteries

Jianyang Liu; Gang Qiao; Gangqiang Zou; Zhigang Sun; Zhenfeng Huang; Wei LU; Xiaosan Chen; Guangfeng LI; Zhidong Zhang

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Experience for 107 patients with acute type A aortic dissection involving coronary arteries

VernacularTitle:107 例急性 A 型主动脉夹层累及冠状动脉的处理经验
Author: Jianyang LIU ^{1
,

2} ; Gang QIAO ^{1
,

2} ; Gangqiang ZOU ^{1
,

2} ; Zhigang SUN ^{1
,

2} ; Zhenfeng HUANG ^{1
,

2} ; Wei LU ^{1
,

2} ; Xiaosan CHEN ^{1
,

2} ; Guangfeng LI ^{1
,

2} ; Zhidong ZHANG ^{1
,

2}
Author Information

1. Henan Provincial People&rsquo
2. s Hospital Heart Centre, Central China Fuwai Hospital, Zhengzhou University Central China Fuwai Hospital, Zhengzhou, 450003, P.R.China
Publication Type:Journal Article
Keywords: Acute aortic dissection; coronary artery; coronary artery bypass grafting
From: Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2020;27(09):1015-1019
CountryChina
Language:Chinese
Abstract: Objective To summarize the clinical feature and treatment experience of patients with acute type A aortic dissection involving coronary arteries. Methods The clinical data of 107 patients with acute type A aortic dissection involving coronary arteries, who received operation between June 5, 2012 and December 31, 2019 in our hospital, were analyzed retrospectively. There were 80 males and 27 females at age of 24-83 (49.8±11.2) years. Results The right coronary artery was involved in 65 patients, the left in 17 patients, and both coronary arteries in 25 patients. There were 48 (44.9%) patients undergoing coronary artery bypass grafting, 49 (45.8%) patients undergoing coronary artery plasty. Fifteen patients died 30 d after the operation, with a mortality rate of 14.0%. Patients with preoperative cardiogenic shock and postoperative acute renal failure had increased risk of death (P<0.05). Eighty-two (88.2%) patients were followed up for 2 to 71 months, and 1 patient had sudden cardiac death during the follow-up period. Conclusion Acute type A aortic dissection with coronary involvement is associated with high misdiagnosis rate and mortality rate. Taking proper strategies for surgical treatment of involved coronary arteries based on precise diagnosis may improve the prognosis of patients.