P151. Identification of factors associated with postoperative hemorrhage in Stanford type A aortic dissection repair

Stephen Huddleston Poster Presenter
Minneapolis, MN 
United States
 - Contact Me

Dr. Huddleston joined the faculty at the University of Minnesota in December 2015 where he is an Associate Professor of Surgery in the Division of Cardiothoracic Surgery, and the Surgical Director of the Lung Transplant Program at the University of Minnesota Medical Center.  As such, his primary academic interest is in lung transplantation with a focus on clinical outcomes and transplant immunology, as well as ex vivo lung perfusion. He has been the site principal investigator for two multicenter clinical trials examining the role of warm ex vivo lung perfusion in lung transplant. The device used for this research, TransMedics Lung OCS, is now FDA approved and expanding the donor pool. Also, he collaborates with world-renowned immunologist Marc Jenkins, PhD using advanced immunologic techniques to detect and characterize CD4+ T cells with specificity for the donor lung in the blood of lung transplant recipients. He is also the Director of the Aortic Center with a strong interest in aortic dissection, repair of thoracic and thoracoabdominal aortic aneurysms, and surgical outcomes after aortic surgery. In addition, he is the Chief of Cardiac Surgery at St. Johns Hospital in Maplewood, MN.

Dr. Huddleston received his medical degree from Columbia University in 2000 and completed his internship and residency in General Surgery at the University of Minnesota.  Dr. Huddleston received his Ph.D. in surgery at University of Minnesota in 2009 defending his thesis, “Graft Antigen-Specific CD4+ T cells require CD154 Expression to Clonally Expand and Differentiate to the Th1 phenotype and initiate mTOR Dependent Intimal Hyperplasia in Cardiac Allografts.” After completing his cardiothoracic surgery training at the Johns Hopkins Hospital in Baltimore, MD, he was a private practice cardiothoracic surgeon at St. Luke’s Hospital in Duluth, MN starting in 2012 until he returned to the University of Minnesota. He is board certified in Surgery and Thoracic Surgery.

Thursday, April 25, 2024: 5:38 PM - 7:00 PM
Sheraton Times Square 
Room: Central Park 

Description

Introduction: Postoperative hemorrhage is one of the leading causes of mortality and reoperation following Stanford type A aortic dissection (TAAD) repair. However, factors associated with postoperative hemorrhage in TAAD remain unclear. This study aimed to use the National Inpatient Sample (NIS), the largest all-payer inpatient care database in the United States, to provide a comprehensive assessment of the preoperative factors for hemorrhage after TAAD.

Methods: Patients who underwent TAAD repair between the last quarter of 2015-2020 were selected from the National Inpatient Sample (NIS) database. Multivariable logistic regression was employed to select preoperative variables that were either predictive or protective of post-operative hemorrhage in TAAD. Multicollinearity tests were examined to confirm independency for the selected factors.

Results: Among 4,282 TAAD cases, there were 3,302 (77.11%) incidences of hemorrhage. The preoperative risk factors for hemorrhage include thrombocytopenia (aOR 3.090, p<0.01), depression (aOR 1.560, p<0.01), renal malperfusion (aOR 1.543, p<0.01), transferred in from a different acute care hospital (aOR 1.285, p<0.01). In contrast, White race (aOR 0.787, p<0.01), elective surgery (aOR 0.768, p=0.02), age < 45 years old (aOR 0.729, p<0.01), drug abuse (aOR 0.669, p=0.02), and coronary malperfusion (aOR 0.591, p<0.01) were protective for hemorrhage following TAAD repair.

Conclusion: The study identified preoperative factors associated with postoperative hemorrhage after TAAD repair. These findings can be insightful for preoperative risk assessment and perioperative management in patients undergoing TAAD repair.

Authors
Qianyun Luo (1), Renxi Li (1), Stephen Huddleston (1)
Institutions
(1) N/A, N/A

Presentation Duration

PODS will be on display in the exhibit hall for the duration of the meeting during exhibit hall hours. PODS will also be available for viewing on the meeting website. There is no formal presentation associated with your POD, but we encourage you to visit the PODS area during breaks to connect with those viewing. 

View Submission