Extent of surgical repair and outcomes 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_____%2F25%3A43928264" target="_blank" >RIV/00064173:_____/25:43928264 - isvavai.cz</a>

Alternative codes found

RIV/00216208:11120/25:43928264

Result on the web

<a href="https://doi.org/10.1093/bjsopen/zraf003" target="_blank" >https://doi.org/10.1093/bjsopen/zraf003</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1093/bjsopen/zraf003" target="_blank" >10.1093/bjsopen/zraf003</a>

Result language

angličtina

Original language name

Extent of surgical repair and outcomes after surgery for type A aortic dissection

Original language description

BACKGROUND: Acute Stanford type A aortic dissection is a severe emergency condition that, if left untreated, is associated with a high mortality rate. The extent of surgical repair may impact the outcomes of these patients. METHOD: Patients operated for acute type A aortic dissection from a multicentre European registry were included. Patients were categorized based on the following types of surgical intervention: isolated ascending aortic replacement, ascending aortic replacement with concomitant aortic valve replacement, aortic root replacement, partial or total arch replacement, and partial or total arch replacement with concomitant aortic root replacement. The primary outcome was mortality rate, both in-hospital and at 10 years. Secondary outcomes were acute kidney injury requiring dialysis, neurological complications, a composite endpoint including in-hospital death, neurological complications and/or dialysis, and proximal endovascular or surgical aortic re-operations at 10 years. RESULTS: 3702 patients were included. The adjusted risk of in-hospital mortality was higher in all subsets of patients compared to those who underwent isolated ascending aortic replacement. The adjusted rates of in-hospital mortality ranged from 16.4% (95% c.i. 15.3 to 17.4) among patients who underwent isolated ascending aortic replacement to 27.7% (95% c.i. 23.3 to 31.2) among those who underwent aortic arch and concomitant aortic root replacement. The adjusted risks of neurological complications, renal replacement therapy and of the composite endpoint were significantly higher in patients who underwent partial/total aortic arch replacement. The adjusted risk estimates of 10-year mortality rate were markedly higher in patients who underwent partial/total aortic arch replacement with or without concomitant aortic root replacement. Extensive aortic repair did not significantly reduce the risk of distal or proximal aortic reoperations. CONCLUSION: These findings suggest that, when feasible, limiting the extent of aortic replacement for acute type A aortic dissection may be beneficial in reducing mortality rate and major complications both in the short and long term. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT04831073.

Czech name

—

Czech description

—

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

2025

Confidentiality

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

Name of the periodical

BJS Open

ISSN

2474-9842

e-ISSN

2474-9842

Volume of the periodical

9

Issue of the periodical within the volume

2

Country of publishing house

GB - UNITED KINGDOM

Number of pages

7

Pages from-to

"zraf003"

UT code for WoS article

001442186100001

EID of the result in the Scopus database

2-s2.0-105000183675