title: [Permanent Neurological Deficit in Surgical Repair for Acute Type A Aortic Dissection].
abstract: BACKGROUND
  This study elucidated incidence and risk factors of permanent neurological deficit( PND) after surgical repair of the acute type A aortic dissection.
  
  
  RESULTS
  669 patients who underwent emergent ascending/hemiarch replacement( AAR/HAR) and total arch replacement (TAR) were analyzed. AAR/HAR was performed in 441(65.9%) and TAR in 228 (34.1%). PND occurred in 58 patients(8.7%). Incidence of PND in AAR/HAR and TAR were 8.4% and 9.2% respectively(p=0.772). Logistic regression analysis showed preoperative conscious disturbance, preoperative paralysis, preoperative myocardial ischemia, and longer operation time associated postoperative PND.
  
  
  CONCLUSIONS
  Rapid initiation of surgery after diagnosis and shorten operation time are advisable to improve outcomes. Preoperative neurological deficit and myocardial ischemia are risk factor of postoperative PND. Incidence of PND in AAR/HAR and TAR was equivalent.
authors.affiliation: Department of Cardiovascular Surgery, Sakakibara Memorial Hospital, Fuchu, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Naito
authors.forename: Hidefumi
authors.initials: H
authors.lastname: Nishida
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Takanashi
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000601:surgery*; D001013:Aorta, Thoracic / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D009422:Nervous System Diseases / Q000209:etiology*; D061646:Operative Time; D011183:Postoperative Complications