Outcome after day- and nighttime surgery for acute type A aortic dissection

被引：0

作者：

Demal, Till Joscha ^{[1
,2
]}

Knochenhauer, Tim ^{[1
]}

Weimann, Jessica ^{[3
]}

Juvonen, Tatu ^{[4
,5
]}

Makikallio, Timo ^{[6
]}

Fiore, Antonio ^{[7
]}

Perrotti, Andrea ^{[8
]}

Pettinari, Matteo ^{[9
]}

Peterss, Sven ^{[10
]}

Buech, Joscha ^{[10
,11
]}

Radner, Caroline ^{[10
,11
]}

Dell'Aquila, Angelo M. ^{[12
]}

Wisniewski, Konrad ^{[13
]}

Pol, Marek ^{[14
]}

Kacer, Petr ^{[14
]}

Onorati, Francesco ^{[15
]}

Francica, Alessandra ^{[15
]}

Vendramin, Igor ^{[16
]}

Piani, Daniela ^{[16
]}

Rinaldi, Mauro ^{[17
]}

Ferrante, Luisa ^{[17
]}

Quintana, Eduard ^{[18
]}

Pruna-Guillen, Robert ^{[18
]}

Lega, Javier Rodriguez ^{[19
]}

Pinto, Angel G. ^{[19
]}

Acharya, Metesh ^{[20
]}

Field, Mark ^{[20
]}

Kuduvalli, Manoj

Nappi, Francesco ^{[21
]}

Gerelli, Sebastien ^{[22
]}

Di Perna, Dario ^{[22
]}

Gatti, Giuseppe ^{[23
]}

Mazzaro, Enzo ^{[23
]}

Rosato, Stefano ^{[24
]}

D'Errigo, Paola ^{[24
]}

Mariscalco, Giovanni ^{[25
]}

El-Dean, Zein ^{[25
]}

Detter, Christian ^{[1
]}

Reichenspurner, Hermann ^{[1
,2
]}

Polvani, Gianluca ^{[26
,27
]}

Biancari, Fausto ^{[26
,27
]}

Conradi, Lenard ^{[28
]}

机构：

[1] Univ Heart & Vasc Ctr Hamburg, Dept Cardiovasc Surg, Martinistr 52, D-20246 Hamburg, Germany

[2] German Ctr Cardiovasc Res, Partner Site Hamburg Kiel Luebeck, Lubeck, Germany

[3] Univ Heart & Vasc Ctr Hamburg, Dept Cardiol, Hamburg, Germany

[4] Univ Helsinki, Helsinki Univ Hosp, Heart & Lung Ctr, Helsinki, Finland

[5] Univ Oulu, Res Unit Surg Anesthes & Crit Care, Oulu, Finland

[6] Univ Helsinki, South Karel Cent Hosp, Dept Med, Lappeenranta, Finland

[7] Henri Mondor Univ Hosp, Assistance Publ Hop Paris, Dept Cardiac Surg, Creteil, France

[8] Univ Franche Comte, Dept Thorac & Cardiovasc Surg, Besancon, France

[9] Clin Univ St Luc, Dept Cardiac Surg, Brussels, Belgium

[10] Ludwig Maximilians Univ Munchen, LMU Univ Hosp, Dept Cardiac Surg, Munich, Germany

[11] German Ctr Cardiovasc Res, Partner Site Munich Heart Alliance, Munich, Germany

[12] Martin Luther Univ Halle Wittenberg, Dept Cardiac Surg, Halle, Germany

[13] Univ Hosp Muenster, Dept Cardiothorac Surg, Munster, Germany

[14] Univ Hosp Kralovske Vinohrady, Dept Cardiac Surg, Prague, Czech Republic

[15] Univ Verona, Sch Med & Surg, Div Cardiac Surg, Verona, Italy

[16] Azienda Sanit Univ Friuli Cent, Cardiothorac Dept, Udine, Italy

[17] Univ Turin, Molinette Hosp, Cardiac Surg, Turin, Italy

[18] Univ Barcelona, Hosp Clin Barcelona, Dept Cardiovasc Surg, Barcelona, Spain

[19] Gen Univ Hosp Gregorio Maranon, Cardiovasc Surg Dept, Madrid, Spain

[20] Liverpool Heart & Chest Hosp, Liverpool Ctr Cardiovasc Sci, Liverpool, England

[21] Ctr Cardiol Nord St Denis, Dept Cardiac Surg, Paris, France

[22] Ctr Hosp Annecy Genevois, Dept Cardiac Surg, Epagny Metz Tessy, France

[23] Azienda Sanit Univ Giuliano Isontina, Cardiothorac & Vasc Dept, Div Cardiac Surg, Trieste, Italy

[24] Natl Inst Hlth, Natl Ctr Global Hlth, Rome, Italy

[25] Glenfield Hosp, Dept Cardiac Surg, Leicester, England

[26] Ctr Cardiol Monzino IRCCS, Dept Cardiac Surg, Milan, Italy

[27] Univ Milan, Dept Biomed Surg & Dent Sci, Milan, Italy

[28] Univ Hosp Cologne, Dept Cardiac Surg, Cologne, Germany

来源：

EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY | 2025年 / 67卷 / 06期

关键词：

Type A aortic dissection; Emergency surgery; Total arch replacement; GERAADA; ERTAAD;

D O I：

10.1093/ejcts/ezaf192

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

OBJECTIVES We aimed to investigate the differences in early and late outcomes after daytime compared to nighttime surgery for type A aortic dissection.METHODS From 2005 to 2021, patients undergoing surgery for type A aortic dissection at 18 European centres participating in the European registry of type A aortic dissection were included in this study. Based on the time of procedure, patients were allocated into groups (8 a.m. to 8 p.m. vs 8 p.m. to 8 a.m.). After propensity-score matching, short- and long-term all-cause mortality and reoperation rate as well as secondary end-points including myocardial infarction, neurological outcome and renal failure were compared.RESULTS A total of 3902 patients were included in this study. After propensity-score matching, outcomes of 1475 pairs of patients were compared. No differences were found regarding rates of surgical techniques. Daytime surgery was associated with an increased rate of global brain injury [daytime 5.4% (n = 80) vs nighttime 3.6% (n = 53); P = 0.021]. No significant differences were found in the rates of myocardial infarction, renal failure or neurological outcome other than global brain ischaemia. Significantly higher 1-year mortality (24.8% vs 21.7%, P = 0.049) and 10-year mortality (48.7% vs 45.1%, P = 0.022) was demonstrated in the daytime group. No significant differences in the rates of reoperation at 10 years were found.CONCLUSIONS This study demonstrates that surgery for type A aortic dissection performed during nighttime is not associated with adverse outcomes compared to daytime surgery, suggesting that nighttime procedures can be safely performed without compromising short- or long-term outcomes.CLINICAL TRIAL REGISTRATION NUMBER European Registry of Type A Aortic Dissection (ERTAAD) (Identifier: NCT04831073. URL: https://clinicaltrials.gov/study/NCT04831073). Acute type A aortic dissection (TAAD) is a life-threatening condition, which requires immediate surgery to reduce mortality [1].

引用

页数：10

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