Relationship Between Renal Function and Renal Artery Involvement in Acute Debakey Type I Aortic Dissection

Authors

  • Yi-Peng Ge, MD Department of Cardiovascular Surgery, Beijing Aortic Disease Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
  • Cheng-Nan Li, MD Department of Cardiovascular Surgery, Beijing Aortic Disease Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
  • Yu Li, MD Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
  • Jun-Ming Zhu, MD Department of Cardiovascular Surgery, Beijing Aortic Disease Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
  • Yong-Min Liu, MD Department of Cardiovascular Surgery, Beijing Aortic Disease Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
  • Jun Zheng, MD Department of Cardiovascular Surgery, Beijing Aortic Disease Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
  • Li-Zhong Sun, MD Department of Cardiovascular Surgery, Beijing Aortic Disease Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China

DOI:

https://doi.org/10.1532/hsf.3023

Keywords:

Acute Debakey type I aortic dissection, Renal artery involvement, Renal function, Computer tomography angiography, Acute kidney injury

Abstract

Background: The aim of this study was to analyse the differences in renal function among various types of renal artery involvement in acute Debakey Type I aortic dissection.

Methods: From January 2016 to January 2018, 304 consecutive patients with acute Debakey type I aortic dissection with renal artery involvement were included. According to computed tomography angiography (CTA) findings, renal artery involvement on one side can be classified into four types: type A, in which a large intimal tear is near the renal artery orifice; type B, the orifice of the renal artery originates entirely from the false lumen; type C, the orifice of the renal artery originates entirely from the true lumen; and type D, a renal artery dissection is observed. All patients underwent aortic repair.

Results: The average age was 46.98±10.64 years. The types of bilateral renal artery involvement were as follows: AB type, four patients (1.32%); AC type, 38 patients (12.50%); AD type, three patients (0.99%); BB type, 13 patients (4.28%); BC type, 140 patients (46.05%); BD type, four patients (1.32%); CC type, 76 patients (25.00%); and CD type, 26 patients (8.55%). One-way ANOVA showed that there was no significant difference in serum creatinine (P = .57) and creatinine clearance rate (P = .08) between the groups. A statistically significant difference in age, gender, body mass index, hypertension history and aortic dissection onset time also was not observed (P > .05). The overall incidence of KDIGO acute kidney injury (AKI) was 49.67%. There was no significant difference in AKI incidence between different types of renal artery involvement after aortic surgery (P = .39). For patients needing renal replacement therapy, CTA showed that enhancement of renal cortex in the arterial phase was low and the boundary between the cortex and medulla was unclear in bilateral kidneys.

Conclusion: The types of renal artery involvement did not affect renal function in the acute phase.

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Published

2020-07-07

How to Cite

Ge, Y.-P., Li, C.-N., Li, Y., Zhu, J.-M., Liu, Y.-M., Zheng, J., & Sun, L.-Z. (2020). Relationship Between Renal Function and Renal Artery Involvement in Acute Debakey Type I Aortic Dissection. The Heart Surgery Forum, 23(4), E465-E469. https://doi.org/10.1532/hsf.3023

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