Type A Aortic Dissection repair in the presence of pericardial effusion

P0362 

Abstract Submission 

Yunxing Xue (1), Vito Domenico Bruno (2), Fudong Fan (1), JUN PAN (1), Qing Zhou (1), Dongjin Wang (1)

(1) Nanjing Drum Tower Hospital, Nanjing, China, (2) IRCCS Galeazzi – Sant’Ambrogio Hospital, Milan, Italy

Yunxing Xue    -  Contact Me
Nanjing Drum Tower Hospital

Vito Domenico Bruno    -  Contact Me
IRCCS Galeazzi – Sant’Ambrogio Hospital

Fudong Fan    -  Contact Me
Nanjing Drum Tower Hospital

JUN PAN    -  Contact Me
Nanjing Drum Tower Hospital

Qing Zhou    -  Contact Me
Nanjing Drum Tower Hospital

Dongjin Wang    -  Contact Me
Nanjing Drum Tower Hospital

Yunxing Xue    -  Contact Me
N/A

Introduction: Type A Aortic Dissection (TAAD) is a life-threatening disease and in rare cases is complicated by cardiac tamponade. We aimed to investigate the outcomes after TAAD surgery in the presence of pericardial effusion in a large tertiary centre.
Methods: From January 2011 to January 2020, 1406 consecutive patients underwent TAAD repair at our centre. After removing patients with no data on the presence of pericardial effusion, the final dataset included 1098 patients which were divided in two groups: 132 (12%) patients presented with signs of pericardial effusion and represented the study group.
Results: The median age was 52 years (IQR: 44 -62) and 26% of the patients were female. Compared with the non-effusion patients, the study group patients were older (median age 57 years vs 52, p <0.01) and presented with lower systolic blood pressure (median 116 vs 136 mmHg, p < 0.01) and higher heart rate (median HR 86 vs 80 bpm, p < 0.01). They also had more signs of peripheral malperfusion such as preoperative stroke (22% vs 8.3%), hemiplegia (4.5% vs 1%), limb ischaemia (22% vs 14%) and alterations of the consciousness (7.6% vs 1.1%). The postoperative outcomes were also worst in these patients with a higher in hospital mortality (29% vs 12%) and prolonged ventilations time (median 44 vs 27 hours).
Conclusion: Pericardial effusion and cardiac tamponade in the presence of TAAD represent life-threatening conditions with significant negative impact on the preoperative clinical status and increased postoperative complications and mortality rates.

Dissection