Postoperative Hepatic Dysfunction After Frozen Elephant Trunk for Type A Aortic Dissection

• DOI: 10.3389/fcvm.2021.739606
• Publication Date: 2021-11-22T06:17:46Z
• Authors: Shenghua Liang; Yanxiang Liu; Bowen Zhang; Yaojun Dun; Hongwei Guo; Xiangyang Qian; Xiaogang Sun
• Keywords: Elephant trunks

Background: This study was aimed to investigate the incidence, risk factors, and outcomes of patients with postoperative hepatic dysfunction (PHD) after frozen elephant trunk (FET) for type A aortic dissection (TAAD). Method: retrospective performed 492 who underwent FET TAAD between 2015 2019. Independent factors PHD were determined by multivariate mixed-effect logistic analysis surgeon-specific factor as a random effect. Results: The incidence 25.4% (n = 125) in our cohort. Patients presented higher early mortality (10.4 vs. 1.1%, p < 0.001), rates acute kidney injury (42.4 12.8%, newly required dialysis (23.2 3.0%, 0.001) compared those without PHD. Moreover, median follow-up period 41.3 months, survival curve worse no group (log-rank whereas it similar excluding died within 30 days 0.761). Multivariable analyses suggested that predicted preoperative aspartate transferase [odds ratio (OR), 1.057; 95% confidence intervals (CI), 1.036-1.079; 0.001], celiac malperfusion (OR, 3.121; CI, 1.008-9.662; 0.048), cardiopulmonary bypass time 1.014; 1.005-1.023; 0.003). Retrograde perfusion 0.474; 0.268-0.837; 0.010) associated reduced Celiac an independent predictor but not midterm survival. Conclusions: increased morbidity, late death transferase, malperfusion, (CPB) time, retrograde