Clinical study on relationship between renal artery involvement and renal function in acute Stanford A aortic dissection_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

GE Yipeng , LI Chengnan , ZHONG Yongliang , XIA Yu , XIAO Fucheng , HU Haiou , ZHENG Tie ,  ZHU Junming , SUN Lizhong

Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, P.R.China;

Corresponding author：

ZHU Junming, Email: anzhenzjm@163.com

Keywords：

Acute Stanford type A aortic dissection; type of renal artery involvement; renal function

DOI：

10.7507/1007-4848.201901013

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the involvement of renal artery in acute Stanford type A aortic dissection (TAAD) using CT angiography (CTA) and to analyze the difference of renal function among different types of renal artery involvement.Methods From January 2016 to November 2017, 151 patients of acute TAAD with renal artery involvement were included in the study. There were 118 males and 33 females, with an average age of 47.93±10.53 years. All patients underwent aortic CTA to confirm the TAAD. According to CTA, involvement of one side of renal artery can be divided into four types: type A, large tear near renal artery orifice, difficult to distinguish true or false lumen; type B, the orifice of the renal artery originates entirely from the false lumen; type C, the orifice of the renal artery originates entirely from the true lumen; type D, renal artery dissection is observed, renal artery intima can be seen. The levels of serum creatinine (sCr) and creatinine clearance (CC) in all groups were analyzed and compared. Results The results of one-way ANOVA analysis showed that there was no significant difference in sCr or CC among the groups (P>0.05). There was no significant difference in age, sex, proportion of hypertension history and onset time among the above groups (P>0.05).Conclusion The three most common types of renal artery involvement were BC type, CC type, and AC type. The types of renal artery involvement do not affect renal function.

Citation： GE Yipeng, LI Chengnan, ZHONG Yongliang, XIA Yu, XIAO Fucheng, HU Haiou, ZHENG Tie, ZHU Junming, SUN Lizhong. Clinical study on relationship between renal artery involvement and renal function in acute Stanford A aortic dissection. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2019, 26(9): 870-873. doi: 10.7507/1007-4848.201901013 Copy

1.	Wu HB, Ma WG, Zhao HL, et al. Risk factors for continuous renal replacement therapy after surgical repair of type A aortic dissection. J Thorac Dis, 2017, 9(4): 1126-1132.
2.	Zhou H, Wang G, Yang L, et al. Acute Kidney injury after total arch replacement combined with frozen elephant trunk implantation: incidence, risk factors, and outcome. J Cardiothorac Vasc Anesth, 2018, 32(5): 2210-2217.
3.	李菲, 刘楠, 董平, 等. Stanford A型主动脉夹层深低温停循环术后急性肾功能衰竭相关因素分析. 中华外科杂志, 2013, 51(12): 1094-1098.
4.	Ma WG, Zheng J, Zhang W, et al. Frozen elephant trunk with total arch replacement for type A aortic dissections: Does acuity affect operative mortality? J Thorac Cardiovasc Surg, 2014, 148(3): 963-970.
5.	Zindovic I, Gudbjartsson T, Ahlsson A, et al. Malperfusion in acute type A aortic dissection: An update from the Nordic Consortium for Acute Type A Aortic Dissection. J Thorac Cardiovasc Surg, 2018 Nov 16. pii: S0022-5223(18)32928-3. doi: 10.1016/j.jtcvs.2018.10.134.[Epubaheadofprint].
6.	Hoogmoed RC, Patel HJ, Kim KM, et al. Acute kidney injury in acute type b aortic dissection: outcomes over 20 years. ann thorac surg. Ann Thorac Surg, 2019, 107(2): 486-492.
7.	Bossard G, Bourgoin P, Corbeau JJ, et al. Early detection of postoperative acute kidney injury by Doppler renal resistive index in cardiac surgery with cardiopulmonary bypass. Br J Anaesth, 2011, 107(6): 891-898.
8.	Qin H, Wu H, Chen Y, et al. Early detection of postoperative acute kidney injury in acute stanford type a aortic dissection with doppler renal resistive index. J Ultrasound Med, 2017, 36(10): 2105-2111.
9.	Chan WH, Huang YC, Weng HH, et al. Analysis of intimal extent and predictors of renal atrophy in patients with aortic dissection. Acta Radiol, 2012, 53(7): 732-741.
10.	Wasung ME, Chawla LS, Madero M. Biomarkers of renal function, which and when? Clin Chim Acta, 2015, 438: 350-357.
11.	Haase M, Mertens PR. Biomarkers: more than just markers! Nephrol Dial Transplant, 2015, 30(1): 33-38.
12.	Redahan L, Murray PT. Biomarkers of drug-induced kidney injury. Curr Opin Crit Care, 2017, 23(6): 463-469.
13.	Wang CC, Lin HS, Huang YL, et al. Renal artery involvement in acute aortic dissection: Prevalence and impact on renal atrophy in non-interventional treatment patients. J Cardiovasc Comput Tomogr, 2018, 12(5): 404-410.
14.	张亚兰, 巴应贵. 急性肾损伤的新型生物标志物研究进展. 医学综述, 2018, 24(22): 4512-4517.
15.	李荣山. 急性肾损伤的生物标志物. 中华肾病研究电子杂志, 2013, 2(3): 134-137.

1. Wu HB, Ma WG, Zhao HL, et al. Risk factors for continuous renal replacement therapy after surgical repair of type A aortic dissection. J Thorac Dis, 2017, 9(4): 1126-1132.
2. Zhou H, Wang G, Yang L, et al. Acute Kidney injury after total arch replacement combined with frozen elephant trunk implantation: incidence, risk factors, and outcome. J Cardiothorac Vasc Anesth, 2018, 32(5): 2210-2217.
3. 李菲, 刘楠, 董平, 等. Stanford A型主动脉夹层深低温停循环术后急性肾功能衰竭相关因素分析. 中华外科杂志, 2013, 51(12): 1094-1098.
4. Ma WG, Zheng J, Zhang W, et al. Frozen elephant trunk with total arch replacement for type A aortic dissections: Does acuity affect operative mortality? J Thorac Cardiovasc Surg, 2014, 148(3): 963-970.
5. Zindovic I, Gudbjartsson T, Ahlsson A, et al. Malperfusion in acute type A aortic dissection: An update from the Nordic Consortium for Acute Type A Aortic Dissection. J Thorac Cardiovasc Surg, 2018 Nov 16. pii: S0022-5223(18)32928-3. doi: 10.1016/j.jtcvs.2018.10.134.[Epubaheadofprint].
6. Hoogmoed RC, Patel HJ, Kim KM, et al. Acute kidney injury in acute type b aortic dissection: outcomes over 20 years. ann thorac surg. Ann Thorac Surg, 2019, 107(2): 486-492.
7. Bossard G, Bourgoin P, Corbeau JJ, et al. Early detection of postoperative acute kidney injury by Doppler renal resistive index in cardiac surgery with cardiopulmonary bypass. Br J Anaesth, 2011, 107(6): 891-898.
8. Qin H, Wu H, Chen Y, et al. Early detection of postoperative acute kidney injury in acute stanford type a aortic dissection with doppler renal resistive index. J Ultrasound Med, 2017, 36(10): 2105-2111.
9. Chan WH, Huang YC, Weng HH, et al. Analysis of intimal extent and predictors of renal atrophy in patients with aortic dissection. Acta Radiol, 2012, 53(7): 732-741.
10. Wasung ME, Chawla LS, Madero M. Biomarkers of renal function, which and when? Clin Chim Acta, 2015, 438: 350-357.
11. Haase M, Mertens PR. Biomarkers: more than just markers! Nephrol Dial Transplant, 2015, 30(1): 33-38.
12. Redahan L, Murray PT. Biomarkers of drug-induced kidney injury. Curr Opin Crit Care, 2017, 23(6): 463-469.
13. Wang CC, Lin HS, Huang YL, et al. Renal artery involvement in acute aortic dissection: Prevalence and impact on renal atrophy in non-interventional treatment patients. J Cardiovasc Comput Tomogr, 2018, 12(5): 404-410.
14. 张亚兰, 巴应贵. 急性肾损伤的新型生物标志物研究进展. 医学综述, 2018, 24(22): 4512-4517.
15. 李荣山. 急性肾损伤的生物标志物. 中华肾病研究电子杂志, 2013, 2(3): 134-137.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical study on relationship between renal artery involvement and renal function in acute Stanford A aortic dissection

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