ArticleJournal of cardiothoracic surgery2019
Extensive aortic surgery in acute aortic dissection type A on outcome - insights from 25 years single center experience.
Article in Journal of cardiothoracic surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Aortic root replacement versus preservation in acute type A aortic dissection repair: meta-analysis of reconstructed time-to-event data.Journal of cardiothoracic surgery · 2025Pooled it
- Cardiopulmonary Bypass Time During Surgery for Acute Type A Aortic Dissection and Mid-Term Survival.Journal of cardiovascular development and disease · 2025Article
- Machine learning-based analysis of factors influencing surgical duration in type A aortic dissection.Frontiers in public health · 2025Article
- Limited vs. Extended Resection of Stanford Type A Acute Aortic Dissections.Medicina (Kaunas, Lithuania) · 2024Article
- The cGAS-STING pathway in cardiovascular diseases: from basic research to clinical perspectives.Cell & bioscience · 2024Review
- Sex-Related Differences Between Patients Undergoing Surgery for Acute Type A Aortic Dissection.Cureus · 2024Article
- The impact of age in acute type A aortic dissection: a retrospective study.Journal of cardiothoracic surgery · 2022Article
- Acute type A aortic dissection and the consequences of a patent false lumen.JTCVS techniques · 2021Article
- LINC01278 Sponges miR-500b-5p to Regulate the Expression of ACTG2 to Control Phenotypic Switching in Human Vascular Smooth Muscle Cells During Aortic Dissection.Journal of the American Heart Association · 2021Article
- Transfusion characteristics and hemostatic conditions in octogenarians undergoing emergency surgery for acute aortic dissection: a retrospective study.JA clinical reports · 2020Article
- Role of proximal and distal tear size ratio in hemodynamic change of acute type A aortic dissection.Journal of thoracic disease · 2020Article
- What is the strategy for strategic arch resection in acute proximal aortic dissection?Journal of thoracic disease · 2020Article
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Authors and funding
10 authors.
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Abstract
backgroundThis single center study compares the different surgical techniques used in the treatment of acute aortic dissection type A (AADA) analyzing the influence of the extent of the surgical approach on outcome.
methodsFrom 1988 to 2012, 407 patients were operated for AADA. The cohort was divided into subgroups according to the surgical approach. These groups were compared with the supracommissural replacement group (SCR; n = 141). Groups included aortic valve sparing techniques (AVS; n = 29), Composite replacement (COMP; n = 119), COMP with total arch replacement (COMP+TAR; n = 27) and SCR with TAR (n = 75).
resultsCompared to SCR alone, operation (p = 0.005), bypass-, cross-clamp and circulatory arrest times were longer in SCR + TAR (all p < 0.001). Moreover, operation, bypass and cross clamp times were longer in COMP+TAR (p = 0.003, p = 0.002 and p < 0.001 respectively). COMP alone and AVS required longer cross-clamp time, too (p < 0,001 and p = 0.002, respectively). Overall 30-day mortality was 21% with the observed lowest rate after AVS (14%, SCR 18%, COMP 25%) but differences in 30-day mortality were not statistically significant. The estimated 10-year survival was 42%, especially AVS demonstrated a good 10-year survival (69%). David technique was superior to Yacoub technique concerning incidence of redo interventions (p = 0.036). Risk factors for early mortality included age, circulatory arrest, general malperfusion, bypass and operation time. Circulatory arrest per se was revealed as risk factor for long-term survival.
conclusionsWithin our single center retrospective study concomitant aortic root repair or aortic arch replacement for AADA demonstrated acceptable early and long-term survival. Circulatory arrest, long bypass and operation times per se might be important risk factors for early mortality. AVS techniques can be performed safely and have good outcomes in acute aortic dissection repair.
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