Current Outcome after Surgery for Type A Aortic Dissection

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064173%3A_____%2F23%3A43925246" target="_blank" >RIV/00064173:_____/23:43925246 - isvavai.cz</a>

Alternative codes found

RIV/00216208:11120/23:43925246

Result on the web

<a href="https://doi.org/10.1097/SLA.0000000000005840" target="_blank" >https://doi.org/10.1097/SLA.0000000000005840</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1097/SLA.0000000000005840" target="_blank" >10.1097/SLA.0000000000005840</a>

Result language

angličtina

Original language name

Current Outcome after Surgery for Type A Aortic Dissection

Original language description

OBJECTIVE: The aim of this study was to evaluate the outcomes of different surgical strategies for acute Stanford type A aortic dissection (TAAD). SUMMARY BACKGROUND DATA: The optimal extent of aortic resection during surgery for acute TAAD is controversial. METHODS: This is a multicenter, retrospective cohort study of patients who underwent surgery for acute TAAD at 18 European hospitals. RESULTS: Out of 3902 consecutive patients, 689 (17.7%) died during the index hospitalization. Among 2855 patients who survived 3 months after surgery, 10-year observed survival was 65.3%, while country-, age- and sex-adjusted expected survival was 81.3%, yielding a relative survival of 80.4%. Among 558 propensity score matched pairs, total aortic arch replacement increased the risk of in-hospital (21.0% vs. 14.9%, P=0.008) and 10-year mortality (47.1% vs. 40.1%, P=0.001), without decreasing the incidence of distal aortic reoperation (10-year: 8.9% vs. 7.4%, P=0.690) compared to ascending aortic replacement. Among 933 propensity score matched pairs, in-hospital mortality (18.5% vs. 18.0%, P=0.765), late mortality (at 10-year: 44.6% vs. 41.9%, P=0.824) and cumulative incidence of proximal aortic reoperation (at 10-year: 4.4% vs. 5.9%, P=0.190) after aortic root replacement was comparable to supracoronary aortic replacement. CONCLUSIONS: Replacement of the aortic root and aortic arch did not decrease the risk of aortic reoperation in patients with TAAD and should be performed only in presence of local aortic injury or aneurysm. The relative survival of TAAD patients is poor and suggests that the causes underlying aortic dissection may also impact late mortality despite surgical repair of the dissected aorta.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30201 - Cardiac and Cardiovascular systems

Project

—

Continuities

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Publication year

2023

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Annals of Surgery

ISSN

0003-4932

e-ISSN

1528-1140

Volume of the periodical

278

Issue of the periodical within the volume

4

Country of publishing house

US - UNITED STATES

Number of pages

8

Pages from-to

"e885"-"e892"

UT code for WoS article

001063772200045

EID of the result in the Scopus database

2-s2.0-85163791706