Adult ; Aneurysm, Dissecting ; etiology ; Coronary Aneurysm ; etiology ; Humans ; Male ; Myocardial Infarction ; etiology ; Wounds and Injuries ; complications

Acute Disease ; Aneurysm, Dissecting ; complications ; Aortic Aneurysm, Thoracic ; complications ; Female ; Humans ; Myocardial Infarction ; etiology

Aneurysm, Dissecting ; etiology ; Aortic Aneurysm ; complications ; Aortic Rupture ; Humans ; Male ; Middle Aged ; Sinus of Valsalva ; Ventricular Septum

Adult ; Aneurysm, Dissecting ; complications ; Coronary Aneurysm ; complications ; Female ; Humans ; Myocardial Bridging ; complications ; Myocardial Infarction ; etiology

Adult ; Aneurysm, Dissecting ; complications ; pathology ; Anterior Wall Myocardial Infarction ; etiology ; Aortic Aneurysm, Thoracic ; complications ; Humans ; Male

Aneurysm, Dissecting ; classification ; surgery ; Aortic Aneurysm ; etiology ; Dilatation, Pathologic ; Humans ; Stents ; adverse effects

OBJECTIVESTo analyze risk factors associated to acute renal failure (ARF) post deep hypothermia circulatory arrest (DHCA) surgery of type A aorta dissection patients, researching correlations to hospital mortality rate.

METHODSThere were 273 samples of type A aorta dissection patients collected between September 2011 and May 2013 , all of which had surgery done under DHCA. Categorize the samples into two groups based on whether postoperative ARF happened: non-ARF group(n = 163) and ARF group(n = 110). Conducted regression analysis correlations between postoperative ARF and mortality and one or more risk factors of gender, age, history of illness, type of aorta dissection, heart functional class, pre- and post-operative serum creatinine (sCr), DHCA time, blood loss and blood transfusion volume, postoperative complications, etc.

RESULTSAmong the 110 samples of ARF group (40.3%), 21 (7.7%) conducted continuous renal replacement therapy (CRRT). Among 16 (5.9%) died in hospital, 3 (1.8%) died with functional renal, 13 (11.8%) died with ARF. Single factor analysis: male (χ(2) = 6.075, P = 0.014), preoperative sCr (t = 2.955, P = 0.004), dissection extended to renal artery(χ(2) = 5.103, P = 0.024), cardiopulmonary by-pass (CBP) time (t = 2.435, P = 0.017), DHCA time (t = 2.215, P = 0.031), average lower limb artery blood pressure during CBP (t = -2.832, P = 0.007), during surgery and 24 h postoperative blood loss (t = 2.157, P = 0.034) and blood transfusion (t = 2.426, P = 0.018), postoperative acute respiratory dysfunction (χ(2) = 36.307, P = 0.000), postoperative endotracheal reintubation (χ(2) = 9.167, P = 0.002), postoperative low blood pressure (χ(2) = 10.202, P = 0.001), postoperative temporary neurological deficits (χ(2) = 7.512, P = 0.006), postoperative infection (χ(2) = 11.088, P = 0.001) were the risk factors for ARF. The logistic regression analysis revealed that preoperative sCr (P = 0.023) and acute respiratory dysfunction (P = 0.011) were independent determinants of ARF; preoperative ARF (P = 0.022), CRRT (P = 0.003) and permanent neurological deficits were independent determinants for hospital mortality.

CONCLUSIONSARF is a common complication of post Type A aorta dissection surgery under DHCA, and is the risk factor of hospital mortality. It is important to enhance peri-operative protection of the renal function.

Acute Kidney Injury ; etiology ; Adult ; Aged ; Aneurysm, Dissecting ; surgery ; Aortic Aneurysm ; surgery ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications ; etiology

Aortic dissection accompanying with preeclampsia during pregnancy can be lethal to both the mother and the fetus and carries a high mortality. Of the 2 preeclampsia patients with aortic dissection, one was Type B aortic dissection, occurring in postpartum period. The patient was treated medically and underwent catheter-based stent-graft treatment with fenestration technique. Another patient was Type A acute dissection, occurring in the third trimester. This patient was undiagnosed and both died. Although extremely rare, aortic dissection might be a possibility in preeclampsia pregnant women, the differential diagnosis of chest and/or epigastric pain in preeclampia patient should be thoroughly investigated and treated.
Adult ; Aneurysm, Dissecting ; diagnosis ; etiology ; Female ; Humans ; Pre-Eclampsia ; physiopathology ; Pregnancy ; Pregnancy Complications, Cardiovascular

Aneurysm, Dissecting/complications* ; Coronary Artery Disease/complications* ; Dyspnea/complications* ; Humans ; Syncope/etiology*

Renal artery dissection may be caused by iatrogenic injury, trauma, underlying arterial diseases such as fibromuscular disease, atherosclerotic disease, or connective tissue disease. Radiological imaging may be helpful in detecting renal artery pathology, such as renal artery dissection. For patients with acute, isolated renal artery dissection, surgical treatment, endovascular management, or medical treatment have been considered effective measures to preserve renal function. We report a case of renal infarction that came about as a consequence of renal artery dissection.
*Accidental Falls ; Adult ; Aneurysm, Dissecting/*complications ; Humans ; Infarction/*etiology ; Kidney Diseases/*etiology ; Male ; Renal Artery/*pathology ; Risk Factors