Abstract
Our objective was to analyze the long term survival of patient operated on for acute type A aortic dissection. Between 1990 and 2010, 226 patients underwent emergency surgical operation for acute type A aortic dissection. We have followed the long-term outcomes. 144 patients were operated on with a supracommissural replacement of the ascending aorta (SCR) and 82 with an aortic root surgery (ARS, including 77 Bentall procedures and 5 Tirone David operations). Aortic cross-clamp was longer in ARS group (150.8 vs. 103.6 min, p<0.0001). Overall in-hospital mortality was lower in ARS group (20% vs. 34%, p 0.03). Median follow-up was 11.6 years. 10-year survival was higher in ARS group (85.7% vs. 65.9%, p 0.03) and 10-year freedom from aortic root reoperation was significantly lower in ARS group (93.4% vs. 82.9%, p 0.02). In a multivariate analysis aortic root surgery was an independent protective factor for proximal reoperations OR 0.393, CI 95% [0.206-0.748], p=0.005. Our study suggests that complete aortic root replacement in type A aortic dissection does not burden short-term outcomes, improves long-term survivals and decreases the rate of late reoperation. Whether this approach has to be preferred in younger patient has to be de...Continue Reading
References
Nov 1, 1995·Circulation·J I FannN E Shumway
Jan 1, 1996·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·M A ErginR B Griepp
Jul 3, 1999·The Annals of Thoracic Surgery·R PessottoA Mazzucco
Jul 29, 1999·The Journal of Thoracic and Cardiovascular Surgery·E NeriC Sassi
Feb 24, 2000·JAMA : the Journal of the American Medical Association·P G HaganK A Eagle
May 2, 2000·The Journal of Thoracic and Cardiovascular Surgery·J F SabikD M Cosgrove
Feb 16, 2002·The Annals of Thoracic Surgery·Natascha Simon-KupilikPaul Simon
Sep 13, 2003·Chest·Sandro GelsominoUgolino Livi
Dec 29, 2004·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Ruggero De PaulisLuigi Chiariello
Feb 24, 2010·The Journal of Thoracic and Cardiovascular Surgery·Santi TrimarchiUNKNOWN International Registry of Acute Aortic Dissection Investigators
Nov 6, 2010·Interactive Cardiovascular and Thoracic Surgery·Lars NiclaussLudwig Karl von Segesser
Dec 3, 2011·Journal of the American College of Cardiology·Robert S BonserErnst Weigang
Dec 31, 2011·The Annals of Thoracic Surgery·Giovanni ConcistrèFrancesco Musumeci
Feb 22, 2012·The Journal of Thoracic and Cardiovascular Surgery·Marco Di EusanioRossella Fattori
Jun 9, 2012·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Jos A BekkersAd J J C Bogers
Dec 27, 2012·The Journal of Thoracic and Cardiovascular Surgery·Gilbert H L TangDavid Spielvogel
Feb 2, 2013·The Annals of Thoracic Surgery·Pietro G MalvindiWim J Morshuis
Citations
Feb 27, 2016·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Sven PeterssJohn A Elefteriades
Nov 25, 2017·Heart and Vessels·Emily PanJarmo Gunn
Sep 18, 2020·Journal of Cardiac Surgery·Wahaj MunirBenjamin Adams
Dec 17, 2019·The Journal of Thoracic and Cardiovascular Surgery·Yuki IkenoYutaka Okita
Nov 5, 2019·Toxicology Letters·Yi TanXiaoWu Peng
Feb 17, 2021·Heart, Lung & Circulation·Andrei M Beliaev, Colleen J Bergin
Apr 22, 2021·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·You Jung OkSuk Jung Choo
Oct 26, 2020·The Annals of Thoracic Surgery·Xiao-Fu DaiLiang-Wan Chen
May 6, 2021·Asian Cardiovascular & Thoracic Annals·Tillana Nirav TarkasBenjamin Adams
May 13, 2021·Seminars in Thoracic and Cardiovascular Surgery·Hesham EllauziJohn A Elefteriades
Jun 12, 2021·The Journal of Thoracic and Cardiovascular Surgery·S Christopher MalaisrieUNKNOWN AATS Clinical Practice Standards Committee: Adult Cardiac Surgery
Oct 8, 2021·Aorta : Official Journal of the Aortic Institute at Yale-New Haven Hospital·Simon Dang VanOlivier Fouquet