ArticleThe Annals of thoracic surgery2019
Volume-Outcome Relationships in Surgical and Endovascular Repair of Aortic Dissection.
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 18 papers.
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Who cites it
18 citing papers in PubMed.
- From routine to rescue: Higher elective aortic surgery volume is associated with improved outcomes after acute type A aortic dissection repair.JTCVS open · 2026Article
- Impact of Surgeon Procedural Volume on Outcomes Following Cervical Disc Arthroplasty: A Retrospective Cohort Study.Cureus · 2026Article
- Acute Aortic Syndromes: A Call for Specialization, Centralization, and Collaboration.JACC. Case reports · 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
- Cut from the same cloth? investigating the personality of interventional and surgical cardiovascular specialists.Langenbeck's archives of surgery · 2025Article
- Hospital volume and outcomes of surgical repair in type A acute aortic dissection: A nationwide cohort study.PloS one · 2025Article
- Hospital Teaching Status and Outcomes in Type B Aortic Dissection: Analysis of More Than 40,000 Patients.Journal of cardiothoracic and vascular anesthesia · 2025Article
- An analysis of early and long-term gender-related outcomes after thoracic endovascular aortic repair.European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2024Observational
- Total Arch vs Hemiarch Repair in Acute Type A Aortic Dissection: Systematic Review and Meta-Analysis of Comparative Studies.CJC open · 2024Review
- Acute type A aortic syndromes: outcomes are independent of aortic root/valve management.Indian journal of thoracic and cardiovascular surgery · 2024Article
- Type A aortic dissection: optimal annual case volume for surgery.European heart journal · 2023Article
- Interinstitutional analysis of the outcome after surgery for type A aortic dissection.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023Observational
- Learning curve for open surgical repair of acute type A aortic dissection.Scientific reports · 2023Article
- Extent of aortic replacement and operative outcome in open proximal thoracic aortic aneurysm repair.JTCVS open · 2022Article
- Frozen elephant trunk in acute type A aortic dissections: frontiers and challenges.Indian journal of thoracic and cardiovascular surgery · 2022Article
- "More or less": management of type A aortic dissections in the endovascular era.Indian journal of thoracic and cardiovascular surgery · 2022Article
- The problems of smaller, rural and remote hospitals: Separating facts from fiction.Future healthcare journal · 2020Article
- The 10 Commandments of Open Aortic Arch Repair.Innovations (Philadelphia, Pa.)Article
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
backgroundAs surgical mortality decreases and endovascular utilization increases, it is unknown whether volume-outcome relationships exist in thoracic aortic dissection repair. We characterized volume-outcome relationships for surgical and endovascular management of thoracic aortic dissection.
methodsPatients aged more than 18 years undergoing repair of thoracic aortic dissection in the United States between 2010 and 2014 were identified in seven all-payer state inpatient administrative databases. Patients were divided into groups based on type of repair: surgical repair of type A dissection (TAAD), surgical repair of type B dissection (TBAD), and endovascular repair (TEVAR). Hierarchical logistic regression models evaluated the association between hospital volume and in-hospital mortality.
resultsOverall in-hospital mortality rate was 13.4% (890 of 6650), highest after TAAD (463 of 2918, 15.9%), followed by TBAD (270 of 1934, 14.0%) and TEVAR (157 of 1798, 8.7%). Volume-outcome relationships for adjusted in-hospital mortality were demonstrated for TAAD and TBAD (P-trend < .001), but not TEVAR (P-trend = .11). Adjusted in-hospital mortality differed most for TAAD (fewer than 3 cases per year: 21%, 95% confidence interval, 18% to 24%; vs 11 or more cases per year: 12%, 95% confidence interval, 8% to 16%; P < .001) and TBAD (fewer than 2 cases per year: 18%, 95% confidence interval, 15% to 22%; vs 11 or more cases per year: 9%, 95% confidence interval, 5% to 12%; P < .001), whereas TEVAR did not differ between quartiles. Adjusted mortality was lower at centers with 26 or more overall annual thoracic dissection repairs, compared with any of the three lower-volume quartiles (P < .001).
conclusionsThis study demonstrated lower mortality at high-volume hospitals for overall repair of aortic dissection, persisting separately for surgical repair of TAAD and TBAD, but not TEVAR. As endovascular technology advances and practice patterns consequently change, analyses should focus on understanding the balance between procedural volume, mortality, and access to care for thoracic aortic dissection.
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