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Abstract：
UNASSIGNED: The study objective was to evaluate the surgical results in patients with acute type A aortic dissection and cerebral malperfusion.
UNASSIGNED: From 2000 to 2019, 234 patients with type A aortic dissection and cerebral malperfusion were stratified into 3 groups: 50 (21%) with syncope (group 1), 152 (65%) with persistent loss of focal neurological function (group 2), and 32 (14%) with coma (group 3). Results were evaluated and compared by univariable and multivariable analyses.
UNASSIGNED: Median age was higher in group 1, and incidence of cardiogenic shock was higher in group 3. The femoral artery was the most common cannulation site, whereas the axillary artery was used in 18% of group 1, 30% of group 2, and 25% of group 3 patients (P = .337). Antegrade cerebral perfusion was performed in more than 80% of patients, and ascending aorta/arch replacement was performed in 40% of group 1, 27% of group 2, and 31% of group 3 (P = .21). In-hospital mortality was 18% in group 1, 27% in group 2, and 56% in group 3 (P = .001). Survival at 5 years is 57.0% in group 1, 57.7% in group 2, and 38.7% in group 3 (P = .0005). On multivariable analysis, age, cardiopulmonary bypass time, and group 3 versus group 2 were independent risk factors for mortality, whereas axillary cannulation was a protective factor.
UNASSIGNED: Patients with aortic dissection and cerebral malperfusion without preoperative coma showed acceptable mortality, and those with coma had a high in-hospital mortality regardless of the type of brain protection. Overall axillary artery cannulation appeared to be a protective factor.
UNASSIGNED: From 2000 to 2019, 234 patients with type A aortic dissection and cerebral malperfusion were stratified into 3 groups: 50 (21%) with syncope (group 1), 152 (65%) with persistent loss of focal neurological function (group 2), and 32 (14%) with coma (group 3). Results were evaluated and compared by univariable and multivariable analyses.
UNASSIGNED: Median age was higher in group 1, and incidence of cardiogenic shock was higher in group 3. The femoral artery was the most common cannulation site, whereas the axillary artery was used in 18% of group 1, 30% of group 2, and 25% of group 3 patients (P = .337). Antegrade cerebral perfusion was performed in more than 80% of patients, and ascending aorta/arch replacement was performed in 40% of group 1, 27% of group 2, and 31% of group 3 (P = .21). In-hospital mortality was 18% in group 1, 27% in group 2, and 56% in group 3 (P = .001). Survival at 5 years is 57.0% in group 1, 57.7% in group 2, and 38.7% in group 3 (P = .0005). On multivariable analysis, age, cardiopulmonary bypass time, and group 3 versus group 2 were independent risk factors for mortality, whereas axillary cannulation was a protective factor.
UNASSIGNED: Patients with aortic dissection and cerebral malperfusion without preoperative coma showed acceptable mortality, and those with coma had a high in-hospital mortality regardless of the type of brain protection. Overall axillary artery cannulation appeared to be a protective factor.
摘要：
未经证实：本研究的目的是评估急性A型主动脉夹层和脑灌注不良患者的手术效果。
UNASSIGNED：从2000年到2019年，将234例A型主动脉夹层和脑灌注不良的患者分为3组：晕厥50例（21％）（第1组），152（65%）局灶性神经功能持续丧失（第2组），32例（14%）昏迷（第3组）。通过单变量和多变量分析对结果进行评估和比较。
UNASSIGNED：第1组的中位年龄较高，第3组的心源性休克发生率较高。股动脉是最常见的插管部位，而第1组18%,第2组30%和第3组25%的患者使用了腋下动脉(P=.337).超过80％的患者进行了顺行脑灌注，1组40%,2组27%,3组31%(P=0.21)进行了升主动脉/弓置换.第1组住院死亡率为18%，第2组为27%，第3组为56%（P=0.001）。第1组5年生存率为57.0%，第2组为57.7%，第3组为38.7%（P=0.0005）。在多变量分析中，年龄,体外循环时间,第3组和第2组是死亡率的独立危险因素，而腋窝插管是一个保护因素。
UNASSIGNED：主动脉夹层和脑灌注不良的患者没有术前昏迷表现出可接受的死亡率，无论使用哪种类型的脑保护，昏迷患者的住院死亡率都很高。整体腋窝动脉插管似乎是一个保护因素。
UNASSIGNED：从2000年到2019年，将234例A型主动脉夹层和脑灌注不良的患者分为3组：晕厥50例（21％）（第1组），152（65%）局灶性神经功能持续丧失（第2组），32例（14%）昏迷（第3组）。通过单变量和多变量分析对结果进行评估和比较。
UNASSIGNED：第1组的中位年龄较高，第3组的心源性休克发生率较高。股动脉是最常见的插管部位，而第1组18%,第2组30%和第3组25%的患者使用了腋下动脉(P=.337).超过80％的患者进行了顺行脑灌注，1组40%,2组27%,3组31%(P=0.21)进行了升主动脉/弓置换.第1组住院死亡率为18%，第2组为27%，第3组为56%（P=0.001）。第1组5年生存率为57.0%，第2组为57.7%，第3组为38.7%（P=0.0005）。在多变量分析中，年龄,体外循环时间,第3组和第2组是死亡率的独立危险因素，而腋窝插管是一个保护因素。
UNASSIGNED：主动脉夹层和脑灌注不良的患者没有术前昏迷表现出可接受的死亡率，无论使用哪种类型的脑保护，昏迷患者的住院死亡率都很高。整体腋窝动脉插管似乎是一个保护因素。
