Predictors of Mortality in Stanford Type A Aortic Dissection Patients with Pericardial Hematoma: A Single Center Experience

Aim: This retrospective study aimed to explore mortality
predictors in patients undergoing surgical repair for
Acute Stanford Type A Aortic Dissection (ATAAD) with
concomitant pericardial hematoma between 2010 and
2022.
Material and Method: Data from 270 patients were
reviewed, focusing on 42 cases with preoperative
pericardial hematoma while excluding Type B dissections,
chronic cases, and redos. Pericardial hematoma
confirmation employed preoperative imaging and
surgical evidence. Hemodynamic instability, defined by
systolic blood pressure <80 mmHg, was assessed.
Results: Hemodynamic instability was observed in 25
(59.5%) patients, and in-hospital mortality stood at
35.7%. Multivariate analysis indicated hemodynamic
instability’s significant predictive role for mortality
(p=0.004). While age, preoperative renal status, and
previous coronary intervention lacked direct associations
with early mortality, hemodynamic instability emerged
as a strong determinant.
Conclusion: This study underscores the paramount
significance of hemodynamic instability in determining
mortality outcomes in patients with pericardial
hematoma and ATAAD undergoing surgical repair.