Surgical strategy for retrograde type A aortic dissection based on long-term outcomes

The Annals of Thoracic Surgery
Keiji KamoharaShigeki Morita

Abstract

The optimal management of a retrograde type A aortic dissection (RAAD) is controversial, and few reports have discussed the long-term outcomes of surgical strategies. To determine the most appropriate strategy, we studied the early and late outcomes of RAAD cases. From 1998 to 2014, 44 patients with RAAD (mean age of 63 ± 11 years) underwent surgical repair. Ascending aortic replacement (AAR) was performed in 21 patients and ascending and total arch replacement (TAR) was performed in 23 patients. Eight of the patients who received TAR underwent complete resection of the primary tear in the distal arch or descending aorta (TAR-R[+]), whereas the remaining 15 patients received elephant trunk implantation as an alternative procedure for tear resection (TAR-R[-]). The early and late outcomes (mean follow-up, 86.5 months) were evaluated. Hospital mortality occurred in 4 of the 44 (9.1%) patients, with no mortalities among the patients undergoing TAR-R[-]. There was a tendency toward a higher incidence of late aorta-related events in the AAR group, with a significantly higher patency rate of the false lumen in the proximal site of the residual aorta compared with the TAR group (p = 0.009). Furthermore, the 5-year rate of freedom from...Continue Reading

References

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Nov 21, 2013·The Journal of Thoracic and Cardiovascular Surgery·Kentaro TamuraTaijiro Sueda

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Citations

Aug 4, 2016·General Thoracic and Cardiovascular Surgery·Gaku UchinoNoriko Kodani
Jan 5, 2018·Interactive Cardiovascular and Thoracic Surgery·Paul P UrbanskiRainer Schmitt
Jan 8, 2019·Journal of Vascular Surgery·Takatoshi HigashigawaHajime Sakuma

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