ArticleWorld journal of surgery2022
Postoperative Stroke After Type A Aortic Dissection Repair: Hemorrhage Versus Ischemia.
Article in World journal of surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- Risk factors and prognosis of postoperative hepatic dysfunction after Stanford type A aortic dissection repair: a systematic review and meta-analysis.Journal of cardiothoracic surgery · 2026Pooled it
- Preoperative Hematocrit Is Not Associated With Stroke After Surgery for Acute Type A Aortic Dissection.Journal of cardiothoracic and vascular anesthesia · 2025Article
- Head-Neck-Aorta CT Angiography in Patients With Acute Type A Aortic Dissection: If, When, and Necessary?JACC. Asia · 2025Article
- Article
- A novel nomogram for predicting prolonged mechanical ventilation after acute type A aortic dissection surgery: a retrospective study investigating the impact of ventilation duration on postoperative outcomes.Annals of medicine · 2024Article
- Postoperative stroke in acute type A aortic dissection: incidence, outcomes, and perioperative risk factors.BMC surgery · 2024Article
- Article
- Painless Aortic Dissection with Catastrophic Consequences Presenting as Sudden Loss of Consciousness with no Prodromal Symptoms.European journal of case reports in internal medicine · 2023Article
- Analysis of risk factors for postoperative acute cerebral infarction in patients with type B aortic dissection.American journal of translational research · 2023Article
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPostoperative stroke is a severe and potentially disabling complication following surgical intervention for acute type A aortic dissection (ATAAD). This retrospective study aims to compare the early and late outcomes between patients who had hemorrhagic and ischemic stroke after undergoing ATAAD repair surgery.
methodsBetween January 2007 and June 2020, a total of 685 consecutive patients underwent ATAAD repair at our institution. Patients who had a preoperative stroke or were unconscious at presentation were excluded from this study. Of the 656 included for analysis, 102 (15.5%) patients had a postoperative stroke confirmed by computed tomography angiography. The strokes were classified into the ischemia group (n = 83, 12.7%) and hemorrhage group (n = 19, 2.9%). Clinical features, surgical information, postoperative complications, modified Rankin Scale (mRS) scores after discharge, and 5-year cumulative survival rates were compared.
resultsDemographics, comorbidities, and presentations of ATAAD were similar between the two groups, except a higher rate of preoperative antithrombotic medication was found in the hemorrhage group. The hemorrhage group was associated with a higher complexity of aortic arch replacement, longer cardiopulmonary bypass, and aortic clamping times than the ischemia group. A higher in-hospital mortality rate (42.1% versus 20.5%; p = 0.048) and a higher median mRS score at the 3-month follow-up after discharge (6[3-6] versus 4[2-6]; p = 0.027) were found in the hemorrhage group. The hemorrhage group showed a lower 5-year cumulative survival rate (23.4% versus 57.8%; p = 0.003) compared with the ischemia group.
conclusionsPostoperative hemorrhagic stroke was associated with poorer neurological outcomes and lower survival rates than those with ischemic stroke. Patients who have complex arch replacement, long cardiopulmonary bypass and aortic clamping times are at risk for postoperative hemorrhagic stroke and should have intensive neurological surveillance for early diagnosis and treatment after ATAAD repair surgery.
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