Clin Res Cardiol 96:Suppl 2 (2007)

P374 - Quality of life after operations for acute aortic dissections type A: A RISK FACTOR ANALYSIS in hospital survivors
 
N. Khaladj1, M. Shrestha1, I. Meyer-Brodnitz2, S. Peterss1, A. Haverich1, C. Hagl1
 
1Klinik für Thorax-, Herz- und Gefäßchirurgie OE 6210, Medizinische Hochschule Hannover, Hannover; 2Klinik für Thorax-, Herz- und Gefäßchirurgie, Medizinische Hochschule Hannover, Hannover;
 
Objective: Assessment of quality of life (QoL) after operations with hypothermic circulatory arrest (HCA) is of increasing interest, especially in patients requiring surgery for acute aortic dissections type A (AADA). This study was undertaken to evaluate factors influencing postoperative QoL in a consecutive cohort of hospital survivors.
Methods: 148 pts underwent surgery for AADA at our institution between 01/96 and 05/04. Early and midterm outcome was assessed and QoL evaluated using our institutional and the Short-Form 36 Health Survey questionnaire (SF-36). Correlations of pre-, intra- and postoperative factors on physical and mental status (SF-36) were investigated.
Result: Early mortality was 25 % (37 pts.), 18 pts (19 %) died during follow-up. Follow-up was completed in 96% with a median of 41 month. SF-36 questionnaire was correctly answered in 81 pts (91 %). There were no differences in QoL compared to a standard population. Postoperative temporary neurological dysfunctions were detectable in 25 pts (29 %) and had no influence on results, whereas permanent neurological dysfunctions (11 pts, 13 %) were associated with a reduced memory (p=0.022) and changes in professional life (p=0.001). HCA-time >25 min had a negative impact on vitality (p=0.034). History of previous cardiac operations (p=0.005), diabetes (p=0.002) and preoperative renal insuffiency (p=0.023), extended cardiopulmonary bypass-time (p=0.03) and ventilation hours (p=0.027) were correlated with a reduced physical status.
Conclusion: Surgery for AADA can be performed with a acceptable Qol compared to a standard population. Nevertheless, risk factor analysis revealed a correlation of multimorbidity, prolonged intra- and postoperative course with reduced physical status in SF-36.
 

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