Long-Term Outcome and Quality of Life in Aortic Type A Dissection Survivors

Abstract

Introduction Acute aortic dissection type A (AADA) is a severe and complex disease that is often linked to diverse, possible complications. Without appropriate surgical treatment approximately 75% of all patients die within 14 days after the onset of symptoms. 1 Because of advances in surgery, anesthesia and medical therapy postoperative outcome is steadily improving. 2-4 Most published literature concerns about surgical outcome, survival of patients, and complications leading to disability. Postoperative QoL comparing physical and psychological status is rarely considered in this view. The following article concerns about long-term outcome and quality of life (QoL) after AADA, and focuses on the changes of QoL concerning physical and mental status. Methods Patient Selection From January 1, 1999, until December 31, 2006, 120 patients received an emergency operation for Stanford type A aortic dissection. All patients were recorded and were asked to answer an SF-36 questionnaire during routine follow-up (FU). Four patients refused FU and seven were lost to FU resulting in 109 patients for this study group. Data Collection Dataset was acquired using SF-36 QoL questionnaire. The first SF-36 questionnaire (FU I) was obtained within 45 AE 32 months after surgery, the second (FU II), 46 AE 10 months thereafter. Some of the patients could not show up for their Keywords ► aortic dissection ► SF-36 ► quality of life ► long-term outcome

Clinical outcomes and quality of life in patients with acute and subacute type B aortic dissection after thoracic endovascular aortic repair

“…The SF-36 questionnaire has been used for measurement of QoL after thoracic aortic surgery, 7 – 9 including patients with acute type A aortic dissection who receive open repair 2 , 3 and aortic surgery, 10 as well as patients with abdominal aortic aneurysm repair. 11 , 12 Two studies examined QoL following TEVAR with and without coverage of the left subclavian artery, 13 , 14 and one study investigated QoL by the Swedish Health-Related Quality of Life Survey questionnaire for patients with conservatively treated acute TBAD.…”

“…TEVAR is mini-invasive, but the effect of other factors on QoL has not been fully evaluated yet. There have only been a few published studies on patients’ QoL after TEVAR, 2 , 3 and postoperative QoL with comparison of acute and subacute TBAD has rarely been considered. Therefore, this study aimed to evaluate the midterm outcomes and QoL in patients with acute and subacute TBAD after TEVAR.…”

Факторы Влияющие На Динамику Качества Жизни После Хирургического Лечения Расслоения Восходящего Отдела И Дуги Аорты

“…Более полная оценка эффективности хирургического лечения с целью выбора оптимальной тактики реабилитации может быть произведена исследованием КЖ, поскольку это понятие является многофакторным, включая в себя экономические, психосоциальные, технологические и медицинские аспекты [8].…”

“…При выполнении протезирования восходящего отдела и дуги аорты возникают не только технические сложности (длительность оперативного вмешательства, ИК), но и необходимость защиты центральной нервной системы во время ОК, так как все перечисленные факторы могут повлиять на КЖ данных пациентов [8]. Несмотря на удобство для хирурга выполнения системной гипотермической ОК ("сухое" операционное поле, хороший доступ), данный метод имеет свои недостатки.…”

Low postoperative blood platelet count may be a risk factor for mortality in patients with acute type A aortic dissection

“…Thus, the perioperative mortality and long-term outcome remain dissatisfaction. [6][7][8][9] One of the causes of poor prognosis is the perioperative abnormal coagulation function. Heparin is necessary for the use of extracorporeal circulation, and it may cause postoperative hemorrhage.Protamine can antagonize the effect of heparin, but it may inhibit platelet function.…”