Abstract:
BACKGROUND:Cerebral protection during surgery for acute aortic dissection type A relies on hypothermic circulatory arrest, either alone or in conjunction with cerebral perfusion. METHODS AND RESULTS:The perioperative and intraoperative conditions of 1558 patients submitted from 44 cardiac surgery centers in German-speaking countries were analyzed. Among patients with acute aortic dissection type A, 355 (22.8%) underwent surgery with hypothermic circulatory arrest alone. In 1115 patients (71.6%), cerebral perfusion was used: Unilateral antegrade cerebral perfusion (ACP) in 628 (40.3%), bilateral ACP in 453 (29.1%), and retrograde perfusion in 34 patients (2.2%). For 88 patients with acute aortic dissection type A (5.6%), no circulatory arrest and arch intervention were reported (cardiopulmonary bypass-only group). End points of the study were 30-day mortality (15.9% overall) and mortality-corrected permanent neurological dysfunction (10.5% overall). The respective values for the cardiopulmonary bypass-only group were 11.4% and 9.1%. Hypothermic circulatory arrest alone resulted in a 30-day mortality rate of 19.4% and a mortality-corrected permanent neurological dysfunction rate of 11.5%, whereas the rates were 13.9% and 10.0%, respectively, for unilateral ACP and 15.9% and 11.0%, respectively, for bilateral ACP. In contrast with the ACP groups, there was a profound increase in mortality when systemic circulatory arrest times exceeded 30 minutes in the hypothermic circulatory arrest group (P<0.001). Mortality-corrected permanent neurological dysfunction correlated significantly with perfusion pressure in the ACP groups. CONCLUSIONS:This study reflects current surgical practice for acute aortic dissection type A in Central Europe. For arrest times less than 30 minutes, hypothermic circulatory arrest and ACP lead to similar results. For longer arrest periods, ACP with sufficient pressure is advisable. Outcomes with unilateral and bilateral ACP were equivalent.
journal_name
Circulationjournal_title
Circulationauthors
Krüger T,Weigang E,Hoffmann I,Blettner M,Aebert H,GERAADA Investigators.doi
10.1161/CIRCULATIONAHA.110.009282subject
Has Abstractpub_date
2011-07-26 00:00:00pages
434-43issue
4eissn
0009-7322issn
1524-4539pii
CIRCULATIONAHA.110.009282journal_volume
124pub_type
杂志文章相关文献
CIRCULATION文献大全abstract::We determined the efficacy, pharmacokinetics, and plasma concentration-response relationships of propafenone, a promising new antiarrhythmic drug. Thirteen patients with frequent and complex ventricular premature beats were studied after receiving four increasing doses, during drug washout and during a randomized doub...
journal_title:Circulation
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1161/01.cir.68.3.589
更新日期:1983-09-01 00:00:00
abstract:BACKGROUND:Coronary heart disease (CHD) mortality is rising in many developing countries. We examined how much of the increase in CHD mortality in Beijing, China, between 1984 and 1999 could be attributed to changes in major cardiovascular risk factors and assessed the impact of medical and surgical treatments. METHOD...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.CIR.0000140668.91896.AE
更新日期:2004-09-07 00:00:00
abstract:BACKGROUND:We conducted a 10-year follow-up of the 11 712 patients with acute myocardial infarction randomized in the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto-1 study, the first large trial assessing thrombolytic therapy. METHODS AND RESULTS:Information on survival at 10 years was obtained for th...
journal_title:Circulation
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1161/01.cir.98.24.2659
更新日期:1998-12-15 00:00:00
abstract::Experimental studies have shown that among dogs with a healed myocardial infarction, depressed baroreflex sensitivity (BRS) identifies a subgroup at higher risk for sudden death. We have examined the relation among BRS, several clinical cardiovascular variables, and subsequent mortality in 78 patients below the age of...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.78.4.816
更新日期:1988-10-01 00:00:00
abstract:BACKGROUND:The hypoxia-inducible transcription factor (HIF) subunits are destabilized via the O(2)-dependent prolyl hydroxylase domain proteins (PHD1, PHD2, and PHD3). We investigated whether inhibition of PHDs via upregulating HIF might promote postischemic neovascularization. METHODS AND RESULTS:Mice with right femo...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.108.813303
更新日期:2009-07-07 00:00:00
abstract::Originally described by Japanese authors in the 1990s, Takotsubo syndrome (TTS) generally presents as an acute myocardial infarction characterized by severe left ventricular dysfunction. TTS, however, differs from an acute coronary syndrome because patients have generally a normal coronary angiogram and left ventricul...
journal_title:Circulation
pub_type: 杂志文章,评审
doi:10.1161/CIRCULATIONAHA.116.027121
更新日期:2017-06-13 00:00:00
abstract:BACKGROUND:Atrial fibrillation is the most common cardiac arrhythmia. Ventricular proarrhythmia hinders pharmacological atrial fibrillation treatment. Modulation of atrium-specific Kir3.x channels, which generate a constitutively active current (I(K,ACh-c)) after atrial remodeling, might circumvent this problem. Howeve...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.113.005019
更新日期:2013-12-24 00:00:00
abstract:BACKGROUND:The cross-talk between vascular endothelial growth factor (VEGF)-A, angiopoietin (Ang), and VE-cadherin coregulates endothelial cell (EC) survival. Cardiac expression of VEGF-A but not its receptor KDR is blunted in dilated cardiomyopathy (DCM). Whether VE-cadherin/Ang function is affected in DCM is unknown....
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.CIR.0000091085.12422.19
更新日期:2003-09-30 00:00:00
abstract:BACKGROUND:Risk factors for obstructive sleep apnea (OSA) and the development of subsequent cardiovascular (CV) complications differ by sex. We hypothesize that the relationship between OSA and high-sensitivity troponin T (hs-TnT), cardiac structure, and CV outcomes differs by sex. METHODS AND RESULTS:Seven hundred fi...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.115.016985
更新日期:2015-10-06 00:00:00
abstract:BACKGROUND:Red blood cell transfusion can both benefit and harm. To inform decisions about transfusion, we aimed to quantify associations of transfusion with clinical outcomes and cost in patients having cardiac surgery. METHODS AND RESULTS:Clinical, hematology, and blood transfusion databases were linked with the UK ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.107.698977
更新日期:2007-11-27 00:00:00
abstract:BACKGROUND:Biventricular direct cardiac compression (DCC) can potentially support the failing heart without the complications associated with a blood/device interface. The effect of uniform DCC on left and right ventricular performance was evaluated in 7 isolated canine heart preparations. METHODS AND RESULTS:A comput...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.99.16.2177
更新日期:1999-04-27 00:00:00
abstract:BACKGROUND:Percutaneous transluminal coronary angioplasty (PTCA) is a widely used and important method of reperfusing coronary arteries. However, it is also associated with serious complications such as acute reocclusion and accelerated restenosis. The factors as well as the mechanisms involved in PTCA-associated compl...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.86.1.56
更新日期:1992-07-01 00:00:00
abstract::Eighteen of 388 patients with chronic bundle branch block, studied electrophysiologically and followed prospectively, had H-V intervals of 80 msec or greater. Five patients were functional class I, five class II, seven class III, and one class IV. Follow-up ranged from 103 to 1919 days (mean 711 +/- 118). Three patien...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.53.4.600
更新日期:1976-04-01 00:00:00
abstract:BACKGROUND:Reduced renal function is associated with a poorer prognosis and increased bleeding risk in patients with acute coronary syndromes and may therefore alter the risk-benefit ratio with antiplatelet therapies. In the Platelet Inhibition and Patient Outcomes (PLATO) trial, ticagrelor compared with clopidogrel re...
journal_title:Circulation
pub_type: 杂志文章,随机对照试验
doi:10.1161/CIRCULATIONAHA.109.933796
更新日期:2010-09-14 00:00:00
abstract:BACKGROUND:Cardiac-targeted expression of truncated K(v)4.2 subunit (K(v)4.2N) reduces transient outward current (I(to)) density, prolongs action potentials (APs), and enhances contractility in 3- to 4-week-old transgenic mice. By 13 to 15 weeks of age, these mice develop severely impaired cardiac function and signs of...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.0000014211.47830.4d
更新日期:2002-04-16 00:00:00
abstract:BACKGROUND:Although echocardiography is commonly performed before coronary artery bypass surgery, there has yet to be a study examining the incremental prognostic value of a complete echocardiogram. METHODS AND RESULTS:Patients undergoing isolated coronary artery bypass surgery at 2 hospitals were divided into derivat...
journal_title:Circulation
pub_type: 杂志文章,多中心研究
doi:10.1161/CIRCULATIONAHA.112.127639
更新日期:2013-01-22 00:00:00
abstract:BACKGROUND:It is not known whether progression of aortic arch (AA) atheroma is associated with vascular events in patients with stroke or transient ischemic attack (TIA). METHODS AND RESULTS:AA atheroma was detected on baseline transesophageal echocardiogram in 167 consecutive patients who had prevalent stroke or TIA....
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.106.671727
更新日期:2007-08-21 00:00:00
abstract:BACKGROUND:The importance of clinical presentation and pretransplantation course on outcome in children with dilated cardiomyopathy listed for heart transplantation is not well defined. METHODS AND RESULTS:The impact of age, duration of illness, sex, race, ventricular geometry, and diagnosis of myocarditis on outcome ...
journal_title:Circulation
pub_type: 杂志文章,多中心研究
doi:10.1161/CIRCULATIONAHA.110.011999
更新日期:2012-08-28 00:00:00
abstract:BACKGROUND:Pulmonary hypertension (PH) is a life-threatening disease. Bone marrow cell transplantation is reported to reduce the development of PH by increasing vascular beds in pulmonary circulation. However, adenoviral overexpression of endothelial nitric oxide synthase (eNOS) in the lung is also known to reduce PH. ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.105.001487
更新日期:2006-07-04 00:00:00
abstract:BACKGROUND:Few data exist regarding the effects of angiotensin converting enzyme inhibitors in patients with regurgitant valvular lesions. We postulated an immediate improvement in cardiac performance with captopril in mitral regurgitation, which, in a hemodynamically compensated group of patients, might be mediated th...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.84.5.2049
更新日期:1991-11-01 00:00:00
abstract::Both the Veterans Administration Cooperative Study and the European Coronary Surgery Study have provided only brief accounts of graft patency rates in their surgically treated patients. In the Veterans Administration Cooperative Study, at an average of 1 year after operation, 69% of the grafts were patent among 208 pa...
journal_title:Circulation
pub_type: 临床试验,杂志文章,评审
doi:
更新日期:1985-12-01 00:00:00
abstract:BACKGROUND:The role of a cluster of risk factors characteristic for the insulin resistance syndrome as a predictor for coronary heart disease (CHD) has not been studied previously. METHODS AND RESULTS:Clustering of cardiovascular risk factors was analyzed by factor analysis to investigate whether these clusters (facto...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.100.2.123
更新日期:1999-07-13 00:00:00
abstract:BACKGROUND:The prevalence, prognostic import, and impact of renal insufficiency on the benefits of ACE inhibitors and beta-blockers in community-dwelling patients with heart failure are uncertain. METHODS AND RESULTS:We analyzed data from a prospective cohort of 754 patients with heart failure who had ejection fractio...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.CIR.0000116764.53225.A9
更新日期:2004-03-02 00:00:00
abstract::A 58-year-old man with hypertensive cardiovascular disease and atrial flutter underwent electrophysiologic studies, including multiple intra-atrial recordings and atrial stimulation. Although the surface ECG suggested the presence of atrial flutter, intra-atrial recordings demonstrated the presence of (1) sinus-like r...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.63.1.80
更新日期:1981-01-01 00:00:00
abstract:BACKGROUND:Adenosine can initiate ischemic preconditioning, and mitochondrial ATP-sensitive potassium (K(ATP)) channels have emerged as the likely effectors. We sought to determine the mechanistic interactions between these 2 observations. METHODS AND RESULTS:The mitochondrial flavoprotein oxidation induced by diazoxi...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.102.7.800
更新日期:2000-08-15 00:00:00
abstract:BACKGROUND:Because complement-mediated vascular injury participates in atherosclerosis and C-reactive protein (CRP) can activate the complement cascade, we sought to determine whether CRP affects the expression of the protective complement-inhibitory factors on the cell surface of endothelial cells (ECs). METHODS AND ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.CIR.0000117087.27524.0E
更新日期:2004-02-24 00:00:00
abstract:BACKGROUND:It is unknown whether adenosine can precondition human myocardium against ischemia in vivo. METHODS AND RESULTS:Thirty patients were randomized to receive a 10-minute intracoronary infusion of adenosine (2 mg/min) or normal saline; 10 minutes later, they underwent percutaneous transluminal coronary angiopla...
journal_title:Circulation
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1161/01.cir.95.11.2500
更新日期:1997-06-03 00:00:00
abstract:BACKGROUND:Cyclooxygenase (COX)-2 expression in the heart increases after myocardial infarction (MI). In murine models of MI, COX-2 inhibition preserves left ventricular dimensions and function. We studied the effect of selective COX-2 inhibition on left ventricular remodeling and function after MI in a pig model. MET...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.106.647230
更新日期:2007-01-23 00:00:00
abstract::Two hundred forty-five patients with variant angina were followed for an average of 80.5 months (range, 36-184 months). Survival rate at 1, 3, 5, and 10 years was 98%, 97%, 97%, and 93%, respectively. Survival rate without myocardial infarction at 1, 3, 5, and 10 years was 86%, 85%, 83%, and 81%, respectively. By univ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.78.1.1
更新日期:1988-07-01 00:00:00
abstract:BACKGROUND:The cellular content of cAMP generated by activation of adenylylcyclase (AC) through the beta-adrenergic receptor (betaAR) is a key determinant of a cell's response to catecholamine stimulation. We tested the hypothesis that increased AC content, independently of betaAR number, increases responsiveness to ca...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.99.12.1618
更新日期:1999-03-30 00:00:00