Survival following acute type A aortic dissection: a multicenter study.

Acute type A aortic dissection (ATAAD) aortic root and arch repair ascending aorta replacement (AAR) total arch replacement procedure (TARP) valve-sparing aorta replacement

Journal

Journal of thoracic disease
ISSN: 2072-1439
Titre abrégé: J Thorac Dis
Pays: China
ID NLM: 101533916

Informations de publication

Date de publication:
30 Dec 2023
Historique:
received: 22 07 2023
accepted: 03 11 2023
medline: 22 1 2024
pubmed: 22 1 2024
entrez: 22 1 2024
Statut: ppublish

Résumé

While surgery is almost always indicated for acute type A aortic dissections (ATAADs), the extent of surgery is often debated, with some surgeons preferring a conservative option and others preferring a more radical option This study aims to assess the outcome after surgery for ATAAD and the prognostic impact of surgical strategy (with Data was gathered between 1 January 2005 and 31 December 2021 and retrospectively analyzed with multivariable logistic and Cox regression to ascertain risk factors and survival respectively. A total of 601 patients underwent type A aortic dissection repair across the recruiting centers with an operative mortality of 24.3% (146 patients) which was considerably linked with the clinical condition at presentation. In-hospital mortality was 23.1% for ascending and root replacement alone Surgery for ATAAD still confers a relatively high mortality. In our study, there was a higher stroke rate associated with patients who underwent arch replacements at the time of dissection despite them being younger. The choice of repair with or without arch replacement should be individualized to the patient and the severity of clinical status presentation.

Sections du résumé

Background UNASSIGNED
While surgery is almost always indicated for acute type A aortic dissections (ATAADs), the extent of surgery is often debated, with some surgeons preferring a conservative option and others preferring a more radical option This study aims to assess the outcome after surgery for ATAAD and the prognostic impact of surgical strategy (with
Methods UNASSIGNED
Data was gathered between 1 January 2005 and 31 December 2021 and retrospectively analyzed with multivariable logistic and Cox regression to ascertain risk factors and survival respectively.
Results UNASSIGNED
A total of 601 patients underwent type A aortic dissection repair across the recruiting centers with an operative mortality of 24.3% (146 patients) which was considerably linked with the clinical condition at presentation. In-hospital mortality was 23.1% for ascending and root replacement alone
Conclusions UNASSIGNED
Surgery for ATAAD still confers a relatively high mortality. In our study, there was a higher stroke rate associated with patients who underwent arch replacements at the time of dissection despite them being younger. The choice of repair with or without arch replacement should be individualized to the patient and the severity of clinical status presentation.

Identifiants

pubmed: 38249919
doi: 10.21037/jtd-23-1137
pii: jtd-15-12-6604
pmc: PMC10797382
doi:

Types de publication

Journal Article

Langues

eng

Pagination

6604-6622

Informations de copyright

2023 Journal of Thoracic Disease. All rights reserved.

Déclaration de conflit d'intérêts

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-23-1137/coif). The authors have no conflicts of interest to declare.

Auteurs

Francesco Nappi (F)

Department of Cardiac Surgery, Centre Cardiologique du Nord, Saint-Denis, France.

Ivancarmine Gambardella (I)

Department of Cardiothoracic Surgery, Weill Cornell Medicine-New York, Presbyterian Medical Center, New York, NY, USA.

Sanjeet Singh Avtaar Singh (SSA)

Department of Cardiothoracic Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK.

Antonio Salsano (A)

Division of Cardiac Surgery, Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy.

Francesco Santini (F)

Division of Cardiac Surgery, Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy.

Cristiano Spadaccio (C)

Department of Cardiothoracic Surgery, Mayo Clinic, Rochester, USA.

Fausto Biancari (F)

Heart and Lung Center, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.

Joaquin Dominguez (J)

Department of Vascular Surgery, Centre Cardiologique du Nord, Saint-Denis, France.

Antonio Fiore (A)

Department of Cardiac Surgery, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France.

Classifications MeSH