• Jana Thurau, Helmut Habazettl, Alaa Abd El Al Md, Alexander Mladenow, Lisa Zaschke, Uyanga Adam Md, Hermann Kuppe, Maximilian Wundram, Marian Kukucka, and Stephan D Kurz Md.
• Institute of Anesthesiology, Deutsches Herzzentrum Berlin, Berlin, Germany; Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Institute of Physiology, Berlin, Germany.
• J. Cardiothorac. Vasc. Anesth. 2019 Jan 1; 33 (1): 51-57.

ObjectiveThe aim of this study was to analyze preoperative and postoperative echocardiographic parameters in patients with type-A acute aortic dissection (ATAAD) and to analyze whether impaired preoperative left ventricular function was associated with short- and long-term survival. To enable multivariable analysis, established risk factors of ATAAD were analyzed as well.DesignRetrospective single-center study.SettingThe German Heart Center Berlin.ParticipantsThe retrospective data of 512 patients with ATAAD who were treated between 2006 and 2014 were analyzed.InterventionsNone.Measurements And Main ResultsPreoperative versus postoperative left ventricular ejection fraction (LVEF), right ventricular ejection fraction, left ventricular end-diastolic diameter, and right ventricular end-diastolic diameter were not significantly different, and the mean values were within the reference ranges. Because of the surgical intervention, incidences and severities of aortic regurgitation and pericardial effusion decreased. In multivariable logistic analysis, the authors identified age (odds ratio [OR] 1.04, p < 0.001), preoperative LVEF ≤35% (OR 2.20, p = 0.003), any ischemia (Penn non-Aa) (OR 2.15, p < 0.001), and longer cardiopulmonary bypass time (OR 1.04, p < 0.001) as independent predictors of 30-day mortality. Cardiopulmonary resuscitation, tamponade, or shock, and pre-existing cardiac disease, were not predictors of death.ConclusionAfter surgery, aortic insufficiency and pericardial effusion decreased, whereas cardiac functional parameters did not change. Severe LV dysfunction was identified as a new independent predictor of 30-day mortality.Copyright © 2018. Published by Elsevier Inc.

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