Perioperative Outcomes of Coronary Artery Bypass Grafting in Acute Type A Aortic Dissection

Authors

  • Chao Hou Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital of Southern Medical University, Guangdong Academy of Medical Sciences, 510080 Guangzhou, Guangdong, China
  • Jiade Zhu Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital of Southern Medical University, Guangdong Academy of Medical Sciences, 510080 Guangzhou, Guangdong, China
  • Jue Yang Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital of Southern Medical University, Guangdong Academy of Medical Sciences, 510080 Guangzhou, Guangdong, China
  • Guang Tong Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital of Southern Medical University, Guangdong Academy of Medical Sciences, 510080 Guangzhou, Guangdong, China
  • Xiang Luo Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital of Southern Medical University, Guangdong Academy of Medical Sciences, 510080 Guangzhou, Guangdong, China
  • Kan Zhou Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital of Southern Medical University, Guangdong Academy of Medical Sciences, 510080 Guangzhou, Guangdong, China
  • Xin Li Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital of Southern Medical University, Guangdong Academy of Medical Sciences, 510080 Guangzhou, Guangdong, China
  • Zerui Chen Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital of Southern Medical University, Guangdong Academy of Medical Sciences, 510080 Guangzhou, Guangdong, China
  • Ruixin Fan Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital of Southern Medical University, Guangdong Academy of Medical Sciences, 510080 Guangzhou, Guangdong, China
  • Tucheng Sun Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital of Southern Medical University, Guangdong Academy of Medical Sciences, 510080 Guangzhou, Guangdong, China
  • Changjiang Yu Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital of Southern Medical University, Guangdong Academy of Medical Sciences, 510080 Guangzhou, Guangdong, China https://orcid.org/0000-0002-5769-9911
  • Jinlin Wu Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital of Southern Medical University, Guangdong Academy of Medical Sciences, 510080 Guangzhou, Guangdong, China https://orcid.org/0000-0003-2997-4565

DOI:

https://doi.org/10.59958/hsf.8079

Keywords:

coronary artery bypass grafting, acute type A aortic dissection, perioperative outcomes, surgical therapy

Abstract

Background: This study aimed to evaluate the perioperative outcomes of concomitant coronary artery bypass grafting (CABG) in patients undergoing surgical repair for acute type A aortic dissection (ATAAD) and to assess the impact of CABG on mortality and complications. Methods: A retrospective analysis was conducted on 1198 ATAAD patients who underwent surgical treatment at our center between January 2016 and December 2022. Patients were categorized into CABG and non-CABG groups. Preoperative characteristics, surgical data, and perioperative outcomes were collected and analyzed. Results: A total of 1198 patients underwent surgical treatment in this study, of whom 979 (81.7%) were male. The mean age was 51.7 ± 11.5 years. Among these patients, 91 (7.6%) underwent concomitant CABG. Patients in the CABG group had significantly higher incidences of chronic coronary artery disease (58.2% vs. 22.6%, p < 0.001), acute myocardial infarction (59.3% vs. 9.5%, p < 0.001), and neurological events (28.6% vs. 18.2%, p = 0.016) compared to the non-CABG group before surgery. Among all patients who underwent surgical treatment, 96 (8.0%) experienced perioperative death. The perioperative mortality rate was significantly higher in the CABG group (39.6% vs. 5.4%, p < 0.001). Patients in the CABG group also had higher rates of postoperative complications, including heart failure, neurological events, continuous renal replacement therapy (CRRT), re-exploration for bleeding, multiple organ dysfunction syndrome (MODS), and need for extracorporeal membrane oxygenation (ECMO) support (all p-values < 0.001). Compared to patients without concomitant CABG, those undergoing CABG had a much higher rate of mortality (Odds Ratio = 2.729, 95% CI = 1.282–5.812, p = 0.009). Conclusions: Concomitant CABG in ATAAD patients was significantly associated with higher perioperative mortality and complication rates.

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Published

2025-01-20

How to Cite

Hou, C. ., Zhu, J. ., Yang, J., Tong, G. ., Luo, X., Zhou, K. ., Li, X., Chen, Z., Fan, R. ., Sun, T. ., Yu, C., & Wu, J. (2025). Perioperative Outcomes of Coronary Artery Bypass Grafting in Acute Type A Aortic Dissection. The Heart Surgery Forum, 28(1), E046–E052. https://doi.org/10.59958/hsf.8079

Issue

Vol. 28 No. 1 (2025)

Section

Article

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