Preoperative and postoperative neurological complications in aortic dissection type A.

PROBLEM: Dissection of ascending aorta (type A) is one of the most urgent and most lethal conditions in medicine. In the first 24 hours after the aortic dissection 50% of patients die if they do not receive appropriate treatment.

OBJECTIVE OF THE RESEARCH: To determine frequency of neurological complication preoperatively and postoperatively in patients with aortic dissection type A.

PATIENTS AND

METHODS

The study was made in 80 patients with acute dissection of ascending aorta treated in German Heart Centre in Berlin during the period of 4 years. Preoperative diagnostic was consisted of: anamnesis, clinical exam, non-invasive (ECHO, CT and MR) and invasive diagnostic methods.

RESULTS

Preoperatively there where 3 patients in each of the study groups 7.5% (6/80) with severe neurological deficit. Postoperative severe neurological complications (coma, hemiparesis, hemiplegia, paraparesis or paraplegia) was recognized in 7.5% (6/80) of patients. Control group with retrograde perfusion had significantly higher rate of postoperative neurological deficit 12.5% (5/40) patients compared with study group with antegrade perfusion 2.5% (1/40) patients.

CONCLUSION

In patients with dissection of ascending aorta (type A), the results of surgical treatment are improved and the rate of postoperative neurological complications is reduced if during the surgical treatment modified arterial perfusion is applied the (antegrade perfusion).