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Preoperative clinical application of human fibrinogen in patients with acute Stanford type A aortic dissection: A Single-center Retrospective Study.
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  • Jia-Hui Li,
  • Qingsong Wu,
  • mirong tang,
  • Yue Shen,
  • Zhihuang Qiu,
  • Xiaodong Chen,
  • Xingfeng Chen,
  • liangwan chen
Jia-Hui Li
Department of Cardiovascular Surgery Union Hospital Fujian Medical University Fuzhou Fujian P RChina

Corresponding Author:ljh3560@sina.com

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Qingsong Wu
Department of Cardiovascular Surgery Union Hospital Fujian Medical University Fuzhou Fujian P RChina
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mirong tang
Department of Cardiovascular Surgery Union Hospital Fujian Medical University Fuzhou Fujian P RChina
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Yue Shen
Department of Cardiovascular Surgery Union Hospital Fujian Medical University Fuzhou Fujian P RChina
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Zhihuang Qiu
Department of Cardiovascular Surgery Union Hospital Fujian Medical University Fuzhou Fujian P RChina
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Xiaodong Chen
Department of Cardiovascular Surgery Union Hospital Fujian Medical University Fuzhou Fujian P RChina
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Xingfeng Chen
Department of Cardiovascular Surgery Union Hospital Fujian Medical University Fuzhou Fujian P RChina
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liangwan chen
Department of Cardiovascular Surgery Union Hospital Fujian Medical University Fuzhou Fujian P RChina
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Abstract

Objective: To evaluate the perioperative clinical efficacy of preoperative human fibrinogen treatment in patients with acute Stanford type A aortic dissection (ATAAD). Methods: Data of 159 patients with ATAAD who underwent emergency surgical treatment in our hospital from January 2019 to December 2020 were retrospectively analyzed. Patients were divided into two groups according to whether human fibrinogen was administered before surgery. The preoperative clinical data, surgical data, postoperative data, complications related to the coagulation function, and mortality of the two groups were compared and analyzed. Results: The in-hospital mortality was similar in the two groups (2.9% versus 9.3%, P = 0.122). However, group A had a significantly shorter operation time (279.24±39.03 versus 298.24±45.90, P=0.008), lower intraoperative blood loss (240.48±96.75 versus 353.70±189.80, P<0.001), and reduced intraoperative transfusion requirement of red blood cells (2.61±1.18 versus 6.05±1.86, P<0.001). The postoperative suction drainage within 24 hours in group A was significantly decreased (243.24±201.52 versus 504.22±341.08,P=0.002). The incidence of postoperative acute kidney injury (AKI) in group A was lower than that in group B (3.8% versus 14.8%, P =0.023). Similarly, the incidence of postoperative hepatic insufficiency in group A was lower than that in group B (1.9% versus 9.3%, P =0.045). In group A, the mechanical ventilation time was shorter (47.68±28.61 versus 118.21±173.16, P=0.004) along with reduced ICU stay time (4.06±1.18 versus 8.09±9.42, P=0.003), and postoperative hospitalization days (19.20±14.60 versus 23.50±7.56, P=0.004). Conclusion: Preoperative administration of human fibrinogen in patients undergoing ATAAD surgery can effectively reduce the intraoperative blood loss, blood transfusion amount, shorten the operation time, reduce postoperative complications, and improve the early prognosis of patients, in addition to being highly safe.
24 Mar 2022Submitted to Journal of Cardiac Surgery
24 Mar 2022Submission Checks Completed
24 Mar 2022Assigned to Editor
25 Mar 2022Reviewer(s) Assigned
08 Jun 2022Review(s) Completed, Editorial Evaluation Pending
09 Jun 2022Editorial Decision: Revise Minor
15 Jun 20221st Revision Received
15 Jun 2022Submission Checks Completed
15 Jun 2022Assigned to Editor
15 Jun 2022Reviewer(s) Assigned
17 Jun 2022Review(s) Completed, Editorial Evaluation Pending
17 Jun 2022Editorial Decision: Accept
Oct 2022Published in Journal of Cardiac Surgery volume 37 issue 10 on pages 3159-3165. 10.1111/jocs.16759