Analysis of Risk Factors of Postoperative Neurological Complications in Patients with Stanford Type A Aortic Dissection Undergoing Sun’s Procedure

Abstract

Objective: This study analyzed the risk factors of neurological complications in patients with Stanford type A aortic dissection after Sun’s procedure in a single-center with the purpose of improving the effects. Methods: From January 2019 to December 2020, the clinical data of 480 patients with Stanford type A aortic dissection, who were treated by Sun’s procedure in our center were retrospectively analyzed. Univariate and multivariate logistic regression analyses were used to determine the risk factors of postoperative neurological complications. According to whether there were neurological complications after surgery, they were divided into two groups: the group with complications (n=70) and the group without complications (n=410). The clinical data of the two groups were collected and compared. Results: There were 70 cases of patients with postoperative neurological complications in 480 cases. The incidence rates of temporary neurological dysfunction (TND) and permanent neurological dysfunction (PND) was 11.5% (55/480) and 3.1% (15/480), respectively. Univariate analysis showed that the age (? 70 years), stroke history, femoral artery intubation and cardiopulmonary bypass (CPB) time were associated with postoperative PND (p < 0.05). Renal dysfunction, emergency surgery, postoperative hypernatremia, postoperative hyperglycemia, postoperative hypoxemia, postoperative low cardiac output syndrome, and assisted time of suction influenced the occurrence of postoperative TND (p < 0.05). Multivariate logistic regression analysis showed that age (? 70 years), stroke history, femoral artery intubation and CPB time were independent risk factors for PND. Renal dysfunction, emergency surgery, postoperative hypernatremia, postoperative hyperglycemia, postoperative hypoxemia, postoperative low cardiac output syndrome, and aspiration time were independent risk factors for TND. Compared with the two groups, the hospitalization time and ICU time of the patients in the neurological complications group were significantly prolonged, and the mortality rate was significantly increased (p < 0.05). Conclusion: There are many risk factors for neurological complications in patients with Stanford type A aortic dissection after surgery. With the improvement of surgical techniques, optimization of cerebral perfusion, and interventions for risk factors, Sun’s procedure remains the preferred treatment for Stanford type A aortic dissection.