loading page

Risk factors of hepatic dysfunction after total arch repair of acute type A aortic dissection with modified triple-branched stent graft implantation
  • +5
  • Linfeng Xie,
  • Debin Jiang,
  • zhihuang qiu,
  • Qingsong Wu,
  • Jun Xiao,
  • Jian He,
  • Yue Shen,
  • liangwan chen
Linfeng Xie
Fujian Medical University Union Hospital

Corresponding Author:lysxxlf@vip.qq.com

Author Profile
Debin Jiang
Fujian Medical University Union Hospital
Author Profile
zhihuang qiu
Author Profile
Qingsong Wu
Fujian Medical University Union Hospital
Author Profile
Jun Xiao
Fujian Medical University Union Hospital
Author Profile
Jian He
Fujian Medical University Union Hospital
Author Profile
Yue Shen
Fujian Medical University Union Hospital
Author Profile
liangwan chen
Fujian Medical University Union Hospital
Author Profile

Abstract

Abstract Background: Hepatic dysfunction (HD) is a serious complication after cardiovascular surgery. However, risk factors of developing hepatic dysfunction after acute type A aortic dissection (AAAD) are largely unclear. Methods: The clinical data of 227 patients with AAAD repaired by modified triple-branched stent graft implantation from January 2018 to January 2020 were collected retrospectively, including preoperative , surgical and postoperative information. Logistics regression was used to explore the potential risk factors of HD. Results: In the early stage after operation, a total of 57 patients were complicated with HD, accounting for 25.11%. The hospital mortality rate in these patients with HD was 19.30%, while the rate in patients without HD was only 6.5%. We found that preoperative body mass index (BMI)>30kg/㎡(OR: 7.054, 95%CI: 1.798-27.678, P=0.005), preoperative renal insufficiency(OR:7.575,95%CI:2.923-19.629, P=0.000),preoperative moderate/severe pericardial effusion(OR: 16.409, 95%CI: 2.81-93.444, P=0.002) and cardiopulmonary bypass time>180min (OR: 7.190, 95%CI: 3.113-16.608, P=0.000) were independent risk factors for HD after AAAD repaired by modified triple-branched stent graft implantation. Conclusions: Preoperative BMI>30kg/㎡, preoperative renal insufficiency, preoperative moderate/severe pericardial effusion and cardiopulmonary bypass time>180min are independent risk factors for HD after total arch repair with modified triple-branched stent graft implantation in AAAD patients. And the occurrence of HD after operation would prolong the time of mechanical ventilation and the hospitalization time of ICU, and significantly increase the in-hospital mortality of patients. Keywords: risk factors,acute type A aortic dissection,hepatic dysfunction, modified triple-branched stent graft implantation, total arch repair