Clinical outcome of emergency cardiac surgery in acute aortic dissection patients combined with COVID-19

Yang Xiaofang; Zhao Xueting; Fu Lin; Guan Ming; Hou Xiaotong; Hei Feilong

doi:10.13498/j.cnki.chin.j.ecc.2024.03.08

Abstract：Objective To investigate the impact of COVID-19 infection on the postoperative outcomes in patients with acute aortic dissection(AAD)undergoing emergency cardiac surgery.Methods Patients with AAD undergoing emergency cardiac surgery under cardiopulmonary bypass(CPB)at Beijing Anzhen Hospital from December 11,2022 to January 30,2023,were continuously collected.They were divided into infection group and non-infection group according to whether infected with COVID-19 during the perioperative period.The clinical data and postoperative outcomes of the two groups of patients were compared.Results A total of 55 patients were included,of which 17(31%)were infected with COVID-19 during the perioperative period,and 38(69%)were non-infected.The proportion of patients with preoperative coronary heart disease[5(29.4%)vs 2(5.3%),P=0.017]and the proportion of postoperative tracheostomy[2(11.8%)vs 0(0%),P=0.033]were significantly higher in the infection group,with statistical significance.The infection group had higher proportions of postoperative pulmonary infection,CRRT and stroke,longer hospital stays,ICU stays and mechanical ventilation times,but the differences were not statistically significant.Conclusion The prognosis of patients with AAD combined with COVID-19 undergoing emergency cardiac surgery under CPB is good.However,patients in the infection group have an increased tendency for complications such as postoperative pulmonary infection,CRRT and stroke compared to the non-infection group.Therefore,such patients should strengthen perioperative management,actively prevent and treat complications such as pulmonary,renal,and cerebral complications,prevent secondary infections and acute embolic events,thereby improving patient prognosis.