Patients
In this retrospective analysis, we reviewed the charts of all patients
who had undergone type A aortic dissection repair operation during the
period 2011 to 2017 in a tertiary care cardiac surgical center in Qatar.
We got prior approval from the Institutional review board (reference
number MRC-01-18-073) and a waiver of informed consent for data
collection was obtained as well.
Data collection:
The patient data was collected anonymously from the electronic medical
records using the prescribed data collection sheet. We included all
patients who underwent AAD surgery except those who didn’t have a
post-operative CK/ Myoglobin value. We also excluded patients with renal
dysfunction prior to surgery.
Laboratory
It is our department protocol to screen all cardiac surgery patients
including aortic dissections with CK and myoglobin in the first day
after surgery and to follow up these values if they are significantly
high.
Patients were divided into two groups based on the collected data –
Group 1- with RML (CK above cut off levels of 2500 U/L) and Group 2
without RML. The determinants of RML and the impact of the same on the
outcome – predominantly renal function was evaluated. Collected data
included preoperative and intraoperative variable potentially affecting
the renal outcome and incidence of RML: Age, body mass index,
preoperative creatinine, Statin use, the delay from onset of symptoms to
surgical intervention, renal artery involvement, duration of surgery,
bypass time, cross-clamp time, circulatory arrest time, propofol dosage,
etc. We also collected data relating to patient outcomes in terms of
mortality and morbidity indicators -focusing mainly on the renal
outcome.