Abstract:

Purpose: Aortic disection is still a major cause of mortality and morbidity today. Many factors affect the outcome of surgery in patients with aortal dysection of type A. A sufficient determination of these factors will affect the success of the treatment. Methods: In our clinic between January 2006 and December 2016 the preoperative, intraoperative, and postoperative data of 140 patients operated with a type A disection diagnosis, patient files and hospital information management system records were retrospective examined. Quantitative parameters between groups were compared with Student t or Mann-Whitney U tests, while qualitative data were compared with Ki-Kare tests. Results: The average age of patients was 57.1±12.3 (min: 27 to max: 84), 31 (22.2 percent) women, 109 (77.8 percent) men. The majority of patients were given an isolated asendan aorta replacement or an asendan aorta replacement (70%). As a brain protection method mostly used antegrad cerebral perfusion (ASP) rarely retrograd cerebral perfusion (RSP). In all patients, the total mortality was 37 people (26.4 percent). The immediate application was found that the systolic pressure was below 90 mmHg, the presence of major neurological deficit, the patient's cardiac surgical history significantly affected the mortality (p<0.05). In patients with mortality, perfusion periods were long, inotropic needs were too high, intensive care periods were statistically significantly increased (p<0.05). In the RSP group, the duration and mortality in intensive care were significantly higher compared to the patients who took ASP (p=0. 2 p = 0.04 . The outcome: the identification of the factors affecting mortality in aortic disorders of type A in larger series of patients and the taking of measures to address these factors may be effective in reducing mortality and morbidity.

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