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Cardiopulmonary Bypass Time During Surgery for Acute Type A Aortic Dissection and Mid-Term Survival

Uimonen, Mikko ; Olsson, Christian ; Jeppsson, Anders ; Geirsson, Arnar ; Hjortdal, Vibeke ; Hansson, Emma C. ; Zindovic, Igor LU ; Ede, Jacob LU orcid ; Gunn, Jarmo and Wickbom, Anders , et al. (2025) In Journal of cardiovascular development and disease 12(4).
Abstract

We evaluated the association between cardiopulmonary bypass (CPB) time during surgery for acute type A aortic dissection (ATAAD) and mid-term survival. Data of 1122 patients who underwent surgery for ATAAD in eight Nordic centers from January 2005 to December 2014 were retrospectively analyzed. An adjusted logistic regression analysis was performed to investigate the association of incremental 30 min CPB time on 30-day mortality. In addition, the patients were divided into those that underwent surgery with >210 min (n = 369) or <210 min CPB time (n = 605) based on spline analysis and a receiver operating characteristic curve. The restricted mean survival time ratios adjusted for patient characteristics and surgical details between... (More)

We evaluated the association between cardiopulmonary bypass (CPB) time during surgery for acute type A aortic dissection (ATAAD) and mid-term survival. Data of 1122 patients who underwent surgery for ATAAD in eight Nordic centers from January 2005 to December 2014 were retrospectively analyzed. An adjusted logistic regression analysis was performed to investigate the association of incremental 30 min CPB time on 30-day mortality. In addition, the patients were divided into those that underwent surgery with >210 min (n = 369) or <210 min CPB time (n = 605) based on spline analysis and a receiver operating characteristic curve. The restricted mean survival time ratios adjusted for patient characteristics and surgical details between the groups were calculated for survival and aortic reoperation-free survival. The median follow-up time was 2.6 (inter-quartile range 0.9–4.9) years. Incremental CPB time was associated with higher 30-day mortality (OR 1.25 per 30 min, 95% CI 1.15–1.35, p < 0.001). Mid-term survival for all patients was inferior in the >210 min group as compared with the <210 min group (adjusted restricted mean survival time ratio 0.88, 95% confidence interval [CI] 0.81–0.96, p = 0.003). Reoperation-free survival was similar in patients with CPB time > 210 min as compared with <210 min. Prolonged CPB time is associated with higher 30-day mortality and inferior mid-term survival but not with inferior reoperation-free survival after surgical repair of ATAAD.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
acute type A aortic dissection, duration of cardiopulmonary time, survival
in
Journal of cardiovascular development and disease
volume
12
issue
4
article number
139
publisher
MDPI AG
external identifiers
  • pmid:40278198
  • scopus:105003435411
ISSN
2308-3425
DOI
10.3390/jcdd12040139
language
English
LU publication?
yes
id
8c075dd6-c79b-4ca0-8e69-0c8c8c94434d
date added to LUP
2025-08-15 13:28:19
date last changed
2025-08-16 03:00:08
@article{8c075dd6-c79b-4ca0-8e69-0c8c8c94434d,
  abstract     = {{<p>We evaluated the association between cardiopulmonary bypass (CPB) time during surgery for acute type A aortic dissection (ATAAD) and mid-term survival. Data of 1122 patients who underwent surgery for ATAAD in eight Nordic centers from January 2005 to December 2014 were retrospectively analyzed. An adjusted logistic regression analysis was performed to investigate the association of incremental 30 min CPB time on 30-day mortality. In addition, the patients were divided into those that underwent surgery with &gt;210 min (n = 369) or &lt;210 min CPB time (n = 605) based on spline analysis and a receiver operating characteristic curve. The restricted mean survival time ratios adjusted for patient characteristics and surgical details between the groups were calculated for survival and aortic reoperation-free survival. The median follow-up time was 2.6 (inter-quartile range 0.9–4.9) years. Incremental CPB time was associated with higher 30-day mortality (OR 1.25 per 30 min, 95% CI 1.15–1.35, p &lt; 0.001). Mid-term survival for all patients was inferior in the &gt;210 min group as compared with the &lt;210 min group (adjusted restricted mean survival time ratio 0.88, 95% confidence interval [CI] 0.81–0.96, p = 0.003). Reoperation-free survival was similar in patients with CPB time &gt; 210 min as compared with &lt;210 min. Prolonged CPB time is associated with higher 30-day mortality and inferior mid-term survival but not with inferior reoperation-free survival after surgical repair of ATAAD.</p>}},
  author       = {{Uimonen, Mikko and Olsson, Christian and Jeppsson, Anders and Geirsson, Arnar and Hjortdal, Vibeke and Hansson, Emma C. and Zindovic, Igor and Ede, Jacob and Gunn, Jarmo and Wickbom, Anders and Gudbjartsson, Tomas and Mennander, Ari}},
  issn         = {{2308-3425}},
  keywords     = {{acute type A aortic dissection; duration of cardiopulmonary time; survival}},
  language     = {{eng}},
  number       = {{4}},
  publisher    = {{MDPI AG}},
  series       = {{Journal of cardiovascular development and disease}},
  title        = {{Cardiopulmonary Bypass Time During Surgery for Acute Type A Aortic Dissection and Mid-Term Survival}},
  url          = {{http://dx.doi.org/10.3390/jcdd12040139}},
  doi          = {{10.3390/jcdd12040139}},
  volume       = {{12}},
  year         = {{2025}},
}