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首页> 外文期刊>Journal of cardiac surgery. >Management of acute type A aortic dissection during COVID-19 outbreak: The Anzhen experience
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Management of acute type A aortic dissection during COVID-19 outbreak: The Anzhen experience

机译：急性型治疗Covid-19爆发期间的主动脉解剖：安珍经验

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摘要

Objectives We seek to report our management protocol and early outcomes of acute type A aortic dissection (ATAAD) repair during the early phase of coronavirus disease 2019 (COVID-19). Methods From January 23 to April 30, 2020, we performed ATAAD repair for 33 patients, including three with pregnancy-related TAADs. Confirmation of COVID-19 depended on the results of two nucleic acid tests and pulmonary computed tomography scan. Based on testing results and hemodynamic stability, patients were triaged to an isolated intensive care unit or negative pressure operating room for emergency surgery. Results Mean age 50.2 +/- 13.3 years and 20 were male (60.1%) and 8 patients were febrile (>37.3 degrees C; 24.2%) and 17 were lymphopenic (51.5%). No patient was excluded from COVID-19 infection preoperatively. Extensive aortic repair with total arch replacement (TAR) was performed in 24 (72.7%), and limited proximal repair in 9 patients (27.3%). Cardiopulmonary bypass and cross-clamp times averaged 177 +/- 34 and 88 +/- 20 min for TAR, and 150 +/- 30 and 83 +/- 18 min for hemiarch, respectively. The mean operation time was 410 +/- 68.3 min. Operative mortality was 6.1% (2/33). Complications included reintubation in four (12.1%), acute kidney failure in two (6.1%), and cerebral infarction in one (3.0%). No paraplegia nor re-exploration for bleeding occurred. COVID-19 was excluded in 100% eventually. No nosocomial infection occurred. Nor did any patient/surgical staff develop fever or test positive during the study period. Conclusions The results of this study show that our management protocol based on testing results and hemodynamic stability in patients with ATAAD during the COVID-19 pandemic was effective and achieved favorable early surgical outcomes.
机译：目的我们试图报告2019年冠状病毒病（COVID-19）早期急性A型主动脉夹层（ATAAD）修复的管理方案和早期结果。方法从2020年1月23日至4月30日，我们对33例患者进行了ATAAD修复，其中3例为妊娠相关TAAD。COVID2019冠状病毒疾病的确诊取决于两种核酸检测结果和肺部CT扫描结果。根据检测结果和血流动力学稳定性，将患者分入隔离的重症监护室或负压手术室进行急诊手术。结果平均年龄50.2+/-13.3岁，男性20例（60.1%），发热（>37.3摄氏度；24.2%）8例，淋巴细胞减少17例（51.5%）。术前未排除2019冠状病毒疾病。24例（72.7%）进行了广泛的主动脉修复和全弓置换（TAR），9例（27.3%）进行了有限的近端修复。TAR患者的体外循环和交叉钳夹时间平均分别为177+/-34和88+/-20分钟，半拱患者的体外循环和交叉钳夹时间平均分别为150+/-30和83+/-18分钟。平均手术时间为410+/-68.3分钟，手术死亡率为6.1%（2/33）。并发症包括再次插管4例（12.1%），急性肾功能衰竭2例（6.1%），脑梗死1例（3.0%）。未发生截瘫或再次探查出血。2019冠状病毒疾病排除在100%。未发生医院感染。在研究期间，也没有任何患者/外科工作人员出现发烧或检测呈阳性。结论本研究2019冠状病毒疾病ATAAD的治疗结果和血流动力学稳定性的管理方案是有效的，并取得了良好的早期手术效果。

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  • 来源
    《Journal of cardiac surgery.》 |2021年第5期|共6页
  • 作者

    Zhang Chen-Han; Ma Wei-Guo; Zhong Yong-Liang; Ge Yi-Peng; Li Cheng-Nan; Qiao Zhi-Yu; Liu Yong-Min; Zhu Jun-Ming; Sun Li-Zhong;

  • 作者单位

    Capital Med Univ Beijing Anzhen Hosp Beijing Inst Heart Lung &

    Blood Vessel Dis Dept Cardiovasc;

    Capital Med Univ Beijing Anzhen Hosp Beijing Inst Heart Lung &

    Blood Vessel Dis Dept Cardiovasc;

    Capital Med Univ Beijing Anzhen Hosp Beijing Inst Heart Lung &

    Blood Vessel Dis Dept Cardiovasc;

    Capital Med Univ Beijing Anzhen Hosp Beijing Inst Heart Lung &

    Blood Vessel Dis Dept Cardiovasc;

    Capital Med Univ Beijing Anzhen Hosp Beijing Inst Heart Lung &

    Blood Vessel Dis Dept Cardiovasc;

    Capital Med Univ Beijing Anzhen Hosp Beijing Inst Heart Lung &

    Blood Vessel Dis Dept Cardiovasc;

    Capital Med Univ Beijing Anzhen Hosp Beijing Inst Heart Lung &

    Blood Vessel Dis Dept Cardiovasc;

    Capital Med Univ Beijing Anzhen Hosp Beijing Inst Heart Lung &

    Blood Vessel Dis Dept Cardiovasc;

    Capital Med Univ Beijing Anzhen Hosp Beijing Inst Heart Lung &

    Blood Vessel Dis Dept Cardiovasc;

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  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 心脏血管和淋巴系外科学;
  • 关键词

    aortic dissection; COVID-19; mortality; nosocomial infection; outcomes; surgery;

    机译：主动脉夹层;Covid-19;死亡率;医院感染;结果;手术;

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