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CC BY-NC-ND 4.0 · Thorac Cardiovasc Surg 2024; 72(02): 105-117
DOI: 10.1055/a-2031-3763
Original Cardiovascular

Role of Helicopter Transfer and Cloud-Type Imaging for Acute Type A Aortic Dissection

Natsuya Ishikawa
1   Department of Cardiac Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
,
Masahiko Narita 
1   Department of Cardiac Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
,
Tomonori Shirasaka 
1   Department of Cardiac Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
,
Ryouhei Ushioda
1   Department of Cardiac Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
,
Masahiro Tsutsui
1   Department of Cardiac Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
,
Nobuyoshi Azuma
2   Department of Vascular Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
,
Hiroyuki Kamiya
1   Department of Cardiac Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
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Abstract

Background This study explored if long-distance transfer was safe for patients suffering from acute aortic dissection type A (AADA) and also analyzed the effectiveness of helicopter transfer and cloud-type imaging transfer systems for such patients in northern Hokkaido, Japan.

Methods and Results The study included 112 consecutive patients who underwent emergency surgical treatment for AADA from April 2014 to September 2020. The patients were divided into two groups according to the location of referral source hospitals: the Asahikawa city group (group A, n = 49) and the out-of-the-city group (group O, n = 63). Use of helicopter transfer (n = 13) and cloud-type telemedicine (n = 20) in group O were reviewed as subanalyses.

Transfer distance differed between groups (4.2 ± 3.5 km in group A vs 107.3 ± 69.2 km in group O; p = 0.0001), but 30-day mortality (10.2% in group A vs 7.9% in group O; p = 0.676) and hospital mortality (12.2% in group A vs 9.5% in group O; p = 0.687) did not differ. Operative outcomes did not differ with or without helicopter and cloud-type telemedicine, but diagnosis-to-operation time was shorter with helicopter (240.0 ± 70.8 vs 320.0 ± 78.5 minutes; p = 0.031) and telemedicine (242.0 ± 75.2 vs 319.0 ± 83.8 minutes; p = 0.007).

Conclusion We found that long-distance transfer did not impair surgical outcomes in AADA patients, and both helicopter transfer and cloud-type telemedicine system could contribute to the reduction of diagnosis-to-operation time in the large Hokkaido area. Further studies are mandatory to investigate if both the systems will improve clinical outcomes.

Keywords

acute aortic dissection type A - long-distance transfer - helicopter - telemedicine

Ethical Approval Statement

This retrospective study was approved by the institutional review board (IRB) (No. 19207), which waived the need for written patient consent because of the retrospective nature of this study. Furthermore, the refusal right was warranted for all patients, as documented on our homepage.




Publication History

Received: 26 July 2022

Accepted: 30 January 2023

Accepted Manuscript online:
09 February 2023

Article published online:
20 March 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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