Current Outcome after Surgery for Type A Aortic Dissection

Kód výsledku v 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>

Nalezeny alternativní kódy

RIV/00216208:11120/23:43925246

Výsledek na webu

<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>

Jazyk výsledku

angličtina

Název v původním jazyce

Current Outcome after Surgery for Type A Aortic Dissection

Popis výsledku v původním jazyce

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.

Název v anglickém jazyce

Current Outcome after Surgery for Type A Aortic Dissection

Popis výsledku anglicky

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.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30201 - Cardiac and Cardiovascular systems

Projekt

—

Návaznosti

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Rok uplatnění

2023

Kód důvěrnosti údajů

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

Název periodika

Annals of Surgery

ISSN

0003-4932

e-ISSN

1528-1140

Svazek periodika

278

Číslo periodika v rámci svazku

4

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

8

Strana od-do

"e885"-"e892"

Kód UT WoS článku

001063772200045

EID výsledku v databázi Scopus

2-s2.0-85163791706