ArticleThe Annals of thoracic surgery2019
Acute Type A Dissection Repair by High-Volume Vs Low-Volume Surgeons at a High-Volume Aortic Center.
Article in The Annals of thoracic surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 3 of them syntheses that pooled it.
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Who cites it
37 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- 2022 ACC/AHA guideline for the diagnosis and management of aortic disease: A report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines.The Journal of thoracic and cardiovascular surgery · 2023Guideline
- Guideline
- 2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines.Journal of the American College of Cardiology · 2022Guideline
- Article
- Regional travel distance is not associated with operative mortality in acute type A aortic dissection.JTCVS open · 2026Article
- A Type-Entry-Malperfusion-Based Propensity Score Matched Analysis Depending on Surgical Expertise in Patients Without Malperfusion Undergoing Surgery for Acute Type A Aortic Dissection.Interdisciplinary cardiovascular and thoracic surgery · 2026Article
- Impact of an On-Call Specialist Aortic Rota Implementation in Acute Type a Aortic Dissection on Outcomes and Repair Complexity: A Retrospective Cohort Study.Interdisciplinary cardiovascular and thoracic surgery · 2025Article
- Case Volume and Experience in Stereotactic Radiation: Analysis of a Prospective Peer Review Program.Advances in radiation oncology · 2025Article
- Impact of primary entry tear locations on outcomes in acute type A aortic dissection.Scientific reports · 2025Article
- Influence of Surgical Expertise on Repair of Acute Type a Aortic Dissection in a Standardized Operative Setting.Journal of clinical medicine · 2025Article
- Anesthetic Management for Proximal Aortic Repair.Seminars in cardiothoracic and vascular anesthesia · 2025Review
- Outcomes of total arch replacement and frozen elephant trunk in acute aortic syndrome.Frontiers in cardiovascular medicine · 2025Article
- Advances and Innovation in Acute Type a Aortic Dissection.Journal of clinical medicine · 2024Review
- The relationship of sex and aortic diameter at the time of acute type A aortic dissection.JTCVS open · 2024Article
- Article
- Aortic arch registry of type a aortic dissection (AoArch) - rationale, design and definition criteria.Journal of cardiothoracic surgery · 2024Observational
- Modelling years of life lost due to acute type A aortic dissection in the German healthcare setting: a predictive study.BMJ open · 2024Article
- Striking a balance when operating for acute type A aortic dissection.Journal of thoracic disease · 2024Article
- Acute type A aortic syndromes: outcomes are independent of aortic root/valve management.Indian journal of thoracic and cardiovascular surgery · 2024Article
- Acute Aortic Syndromes from Diagnosis to Treatment-A Comprehensive Review.Journal of clinical medicine · 2024Review
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPrevious studies suggest improved outcomes for acute type A dissections (ATAAD) treated at high-volume centers. It is unclear if outcomes are a result of individual surgeon experience or inherent resources available at high-volume centers. To explore this question, we stratified outcomes for ATAAD repair by low-volume and high-volume surgeons at a high-volume center.
methodsWe reviewed our institutional experience with ATAAD between 1999 and 2016 (n = 580). To evaluate surgeon experience with ATAAD repair, we categorized surgeons as high-volume aortic surgeons (HVASs) (> 10 cases/year) or low-volume aortic surgeons (LVASs) (≤ 10 cases/year). Analysis was stratified according to the following: HVAS in primary and first assist roles, HVAS as primary with LVAS as first assist, LVAS as primary and HVAS as first assist, and LVAS in both roles.
resultsThe total experience for HVAS and LVAS as primary surgeon for the study period was 513 and 67, respectively. Mean annual experience as primary surgeon was 15.2 cases for HVAS and 3.4 cases for LVAS. In-hospital mortality was 14.0% if an HVAS was present and 24.0% with an all-LVAS team (P = .27). After adjusting for preoperative factors, the mortality odds ratio (OR) for an all-LVAS team was 3.72 (P = .01).
conclusionsATAAD repair by an all-LVAS team had nearly a 4-fold increase in-hospital mortality compared with an all-HVAS team. Improved outcomes at high-volume centers may be predominantly due to surgeon experience and not from center-specific resources. This study may have implications on call coverage for ATAAD repair at high-volume centers.
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