ArticleTherapeutic advances in cardiovascular disease2018
Impact of ascending aortic, hemiarch and arch repair on early and long-term outcomes in patients with Stanford A acute aortic dissection.
Article in Therapeutic advances in cardiovascular disease, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Outcomes of hemi- vs. total arch replacement in acute type A aortic dissection: A systematic review and meta-analysis.Frontiers in cardiovascular medicine · 2022Pooled it
- Molecular mechanisms of programmed cell death in aortic dissection and advances in clinical translation.Molecular biology reports · 2026Review
- Innominate Artery Translocation with Hemiarch Replacement Strategy for Acute Type A Aortic Dissection: a Single-Center Study.Aorta (Stamford, Conn.) · 2024Article
- Clinical outcome of a branch-first approach with a novel continuous whole-brain perfusion strategy for total arch surgery.Journal of cardiothoracic surgery · 2024Article
- The Clinical Impact of the Extension of Acute Type A Aortic Surgery on Long-Term Outcomes: Should We Tend to Be Conservative?Medicina (Kaunas, Lithuania) · 2023Observational
- Total aortic arch replacement in acute type A aortic dissection - a single institutional experience.Indian journal of thoracic and cardiovascular surgery · 2023Article
- The effect of adding an open distal anastomosis to proximal aneurysm repairs in bicuspid aortopathy.General thoracic and cardiovascular surgery · 2023Article
- Early Results of a Novel Hybrid Prosthesis for Treatment of Acute Aortic Dissection Type A With Distal Anastomosis Line Beyond Aortic Arch Zone Zero.Frontiers in cardiovascular medicine · 2022Article
- Cardiac surgery 2018 reviewed.Clinical research in cardiology : official journal of the German Cardiac Society · 2019Review
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18 authors.
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Abstract
background: Stanford A acute aortic dissection (AAD) is a life-threatening emergency associated with major morbidity and mortality. The aim of this study was to compare outcomes of three different surgical approaches in patients with Stanford A AAD.
methods: From January 2006 to March 2015 a total of 240 consecutive patients with diagnosed Stanford A AAD underwent elective, isolated surgical aortic repair in our centre. Patients were divided into three groups according to the extent of surgical repair: isolated replacement of the ascending aorta, hemiarch replacement and total arch replacement. Patients were followed up for up to 9 years. After univariate analysis multinomial logistic regression was performed for subgroup analysis. Baseline characteristics and endpoints as well as long-term survival were analysed.
results: There were no statistically significant differences among the three groups in terms of demographics and preoperative baseline and clinical characteristics. Incidence of in-hospital stroke ( p = 0.034), need for reopening due to bleeding ( p = 0.031) and in-hospital mortality ( p = 0.017) increased significantly with the extent of the surgical approach. There was no statistical difference in terms of long-term survival ( p = 0.166) among the three groups. Applying multinomial logistic regression for subgroup analysis significantly higher odds for stroke ( p = 0.023), reopening for bleeding ( p = 0.010) and in-hospital mortality ( p = 0.009) for the arch surgery group in comparison to the ascending aorta surgery group as well as significantly higher odds for stroke ( p = 0.029) for the total arch surgery group in comparison to the hemiarch surgery group were identified.
conclusions: With Stanford A AAD the incidence of perioperative complications increased significantly with the extent of the surgical approach. Subgroup analysis and long-term follow up in patients undergoing isolated ascending or hemiarch surgery showed a lower incidence of cerebrovascular events compared with surgery for total arch replacement.
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