Background The purpose of this study is to identify the risk factors for postoperative severe hypoxemia after surgery for acute type A aortic dissection. Methods This was a single-center retrospective study including 112 consecutive patients undergoing urgent aortic arch surgery for acute type A aortic dissection between December 2016 and April 2017 at Beijing Anzhen Hospital. Results Multivariate logistic regression analysis identified female (OR, 12.978; 95% CI, 3.332 to 50.546; p < 0.001) and increased body mass index (OR, 1.473; 95% CI, 1.213 to 1.789; p < 0.001) as independent predictors of postoperative severe hypoxemia in patients with acute type A aortic dissection. Conclusions Obesity and female were independent risk factors for postoperative severe hypoxemia in patients with acute type A aortic dissection. More attention should be paid to preventing postoperative severe hypoxemia in obese women with acute type A aortic dissection.
We herein describe our *These authors contributed equally to this work.experience with a congenital innominate artery aneurysm (IAA) that was managed with a simple surgical procedure. A 44-year-old woman was admitted for chest distress. Computed tomography angiography showed a 3.6-cm IAA arising from the aortic arch and compressing the trachea. A median sternotomy was performed with the patient under general anesthesia, and the IAA was found to involve the origin of the innominate artery and the bifurcation of the right subclavian artery and common carotid artery; however, the aorta was intact. An 8-mm Dacron graft was anastomosed to the ascending aorta and distal end of the IAA without cardiopulmonary bypass. The postoperative course was uneventful, and repeat computed tomography angiography revealed no evidence of recurrence 6 months postoperatively. We also herein present a literature review of this rare clinical condition.
Matrix metalloproteinases-2 (MMP-2) plays an important role in the pathogenesis of type A aortic dissection (AD). The aim of this study was to evaluate the association of 3 single nucleotide polymorphisms (SNPs) in the MMP-2 gene with type A AD risk and aortic diameters in patients. We performed a case–control study with 172 unrelated type A AD patients and 439 controls. Three SNPs rs11644561, rs11643630, and rs243865 were genotyped through the MassARRAY platform. Allelic associations of SNPs and SNP haplotypes with type A AD and aortic diameters in patients were evaluated. The frequency of the G allele of the rs11643630 polymorphism was significantly lower in type A AD patients than in control subjects (odds ratio 0.705, 95% confidence interval 0.545–0.912, P = 0.008). The association remained significant after adjusting for clinical covariates (P = 0.008). Carriers of the GG genotype of the rs11643630 polymorphism had significantly smaller aortic diameters than those with GT genotype or TT genotype (P = 0.02). Further haplotype analysis identified 1 protective haplotype (GC; P = 0.008) for development of type A AD. Again, a significant correlation was observed between haplotype GC and AD size (P = 0.020). Our results suggest that MMP-2 gene polymorphisms contribute to type A AD susceptibility. In addition, MMP-2 gene SNPs are associated with AD size, which could be used as a target for the development of new drug therapy.
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