Predictors of Mortality in Stanford Type A Aortic Dissection Patients with Pericardial Hematoma: A Single Center Experience

Mortality in Dissection Patients with Pericardial Hematoma

Abstract

Background: This retrospective study aimed to explore mortality predictors in patients undergoing surgical repair for Acute Stanford Type A Aortic Dissection (ATAAD) with concomitant pericardial hematoma between 2010 and 2022.

Methods: Data from 270 patients were reviewed, focusing on 42 cases with preoperative pericardial hematoma while excluding Type B dissections, chronic cases, and redos. Pericardial hematoma confirmation employed preoperative imaging and surgical evidence. Hemodynamic instability, defined by systolic blood pressure <80 mmHg due to conditions like cardiac tamponade, was assessed.

Results: Hemodynamic instability was observed in 25 (59.5%) patients, and in-hospital mortality stood at 35.7%. Multivariate analysis indicated hemodynamic instability's significant predictive role for mortality (p=0.004). While age, preoperative renal status, and previous coronary intervention lacked direct associations with early mortality, hemodynamic instability emerged as a strong determinant.

Conclusions: This study underscores the paramount significance of hemodynamic instability in determining mortality outcomes in patients with pericardial hematoma and ATAAD undergoing surgical repair.