Experiencia y resultados en cirugía de disección aórtica tipo A durante una década en la Fundación Valle del Lili, Cali, Colombia / Experience and results in surgery of type A aortic dissection during a decade in the Fundación Valle del Lili, Cali, Colombia
Rev. colomb. cardiol
; 20(5): 325-330, set.-oct. 2013. ilus, graf, tab
Article
em Es
| LILACS, COLNAL
| ID: lil-701761
Biblioteca responsável:
CO369.9
RESUMEN
Antecedentes la disección aórtica tipo A continúa siendo una enfermedad con alto riesgo de muerte, que por ende requiere un diagnóstico rápido y manejo quirúrgico inmediato. Objetivo:
reportar la experiencia y los resultados en cirugía de disección aórtica tipo A durante una década.Métodos:
se realizó un estudio descriptivo, retrospectivo, mediante la revisión de historias clínicas de los pacientes atendidos entre enero de 2001 y diciembre de 2010. Se seleccionaron 58 pacientes con diagnóstico de disección aórtica tipo A, que cumplían con los criterios de inclusión y se analizaron variables demográficas, clínicas, intra y post-operatorias.Resultados:
79,3% de los pacientes fueron hombres; con una mediana de edad de 56 años. Los tiempos promedio para pinza aórtica, bomba y arresto fueron 136, 223 y 39 minutos, respectivamente. Los procedimientos más frecuentes fueron reemplazo de aorta ascendente y cirugía de Bentall en 34,5% de los casos cada uno. La mediana de estancia en la unidad de cuidado intensivo fue de seis y doce días para el total de hospitalización. Se reportaron complicaciones en 36,2% de los casos; la principal fue sepsis de cualquier causa en 20% de los pacientes. La mortalidad intrahospitalaria fue de 24% y la supervivencia a 28 días fue superior a 70%.Conclusiones:
según nuestra casuística, la mortalidad observada no difiere mucho a la que se reporta en registros multicéntricos internacionales, en los cuales sigue siendo elevada, lo cual resalta la importancia del diagnóstico temprano y el manejo quirúrgico inmediato, que implica un esfuerzo humano e institucional considerable. Palabras clave síndrome aórtico agudo, disección de aorta, cirugía cardíaca, mortalidad.Background:
type A aortic dissection is still a disease with a high risk of death. Therefore it requires prompt diagnosis and immediate surgical management.Objective:
to report our experience and results in surgery of type A aortic dissection during a decade.Methods:
a descriptive, retrospective study, by reviewing medical records of patients treated between January 2001 and December 2010 was realized. 58 patients diagnosed as type A aortic dissection who met the inclusion criteria were selected, and demographic, clinical, intra and post-operative variables were analyzed.Results:
79.3% of the patients were men, with a median age of 56 years. The mean times for aortic clamp, pump and arrest were 136, 223 and 39 minutes, respectively. The most frequent procedures were ascending aortic replacement and Bentall surgery in 34.5% of cases each one. The median stay in the ICU was six days and overall hospitalization was twelve days. Complications were reported in 36.2% of cases. The main one was sepsis from any cause in 20% of patients. In-hospital mortality was 24% and survival at 28 days was higher than 70%.Conclusions:
according to our casuistics, the observed mortality is not very different to that reported in international multicenter registries which remains still high. This fact highlights the importance of early diagnosis and immediate surgical management, implying a significant human and institutional effort.ABSTRACT
Background:
type A aortic dissection is still a disease with a high risk of death. Therefore it requires prompt diagnosis and immediate surgical management.Objective:
to report our experience and results in surgery of type A aortic dissection during a decade.Methods:
a descriptive, retrospective study, by reviewing medical records of patients treated between January 2001 and December 2010 was realized. 58 patients diagnosed as type A aortic dissection who met the inclusion criteria were selected, and demographic, clinical, intra and post-operative variables were analyzed.Results:
79.3% of the patients were men, with a median age of 56 years. The mean times for aortic clamp, pump and arrest were 136, 223 and 39 minutes, respectively. The most frequent procedures were ascending aortic replacement and Bentall surgery in 34.5% of cases each one. The median stay in the ICU was six days and overall hospitalization was twelve days. Complications were reported in 36.2% of cases. The main one was sepsis from any cause in 20% of patients. In-hospital mortality was 24% and survival at 28 days was higher than 70%.Conclusions:
according to our casuistics, the observed mortality is not very different to that reported in international multicenter registries which remains still high. This fact highlights the importance of early diagnosis and immediate surgical management, implying a significant human and institutional effort.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
COLNAL
/
LILACS
Assunto principal:
Anel Vascular
Tipo de estudo:
Clinical_trials
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Limite:
Humans
/
Male
País/Região como assunto:
America do sul
/
Colombia
Idioma:
Es
Revista:
Rev. colomb. cardiol
Assunto da revista:
CARDIOLOGIA
Ano de publicação:
2013
Tipo de documento:
Article
País de afiliação:
Colômbia
País de publicação:
Colômbia