Aortic root surgery improves long-term survival after acute type A aortic dissection

International Journal of Cardiology
Ilir HysiAndré Vincentelli

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

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Citations

Feb 27, 2016·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Sven PeterssJohn A Elefteriades
Sep 18, 2020·Journal of Cardiac Surgery·Wahaj MunirBenjamin Adams
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

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