ArticleThe Lancet regional health. Europe2021
Decade-long trends in surgery for acute Type A aortic dissection in England: A retrospective cohort study.
Article in The Lancet regional health. Europe, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 3 of them syntheses that pooled it.
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Who cites it
29 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Risk factors and prognosis of postoperative hepatic dysfunction after Stanford type A aortic dissection repair: a systematic review and meta-analysis.Journal of cardiothoracic surgery · 2026Pooled it
- The role of delayed aortic surgery in type A aortic dissection and mesenteric ischemia: a systematic review and meta-analysis.Journal of cardiothoracic surgery · 2023Pooled it
- Outcomes of surgery for acute type A dissection in octogenarians versus non-octogenarians: a systematic review and meta analysis.Journal of cardiothoracic surgery · 2022Pooled it
- Trainee exposure to valve surgery in the UK: safety, decline and organisational inequality in a national cohort.Open heart · 2026Article
- The Aorta Is One Organ; Our Response Is Not: A Global Case for Systems Redesign in Acute Aortic Syndromes.Journal of clinical medicine · 2026Review
- Article
- The aortic window: a temporal framework for acute type A aortic dissection.Annals of cardiothoracic surgery · 2026Article
- Early clinical outcomes in emergency CABG in the United Kingdom.Frontiers in cardiovascular medicine · 2026Article
- Aortic dissection mortality in the United States, 1968-2023: Trends, disparities, and deep learning forecasts.International journal of cardiology. Cardiovascular risk and prevention · 2025Article
- Reoperative surgery for early- and late-onset prosthetic valve endocarditis: temporal trends and outcomes.Interdisciplinary cardiovascular and thoracic surgery · 2025Article
- External validation of the German Registry for Acute Aortic Dissection Type A score in patients undergoing surgery for acute type A aortic dissection.JTCVS open · 2025Article
- Factors associated with symptom-to-surgery time in patients undergoing surgical repair for acute type A aortic dissection: an exploratory analysis from a prospective cohort study.BMJ surgery, interventions, & health technologies · 2025Article
- Survival after surgery for acute type A aortic dissection in octogenarians.Journal of geriatric cardiology : JGC · 2024Article
- Contemporary comparative surgical outcomes of type A aortic dissection in US and China: an analysis of the national inpatient sample database and a Chinese multi-institutional registry.Journal of cardiothoracic surgery · 2024Article
- A machine learning algorithm-based risk prediction score for in-hospital/30-day mortality after adult cardiac surgery.European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2024Article
- Acute Type A aortic dissection surgical repair in Octogenarians: A meta-analysis.NPJ cardiovascular health · 2024Review
- Two Decades of CABG in the UK: A Propensity Matched Analysis of Outcomes by Conduit Choice.Journal of clinical medicine · 2024Article
- Modelling years of life lost due to acute type A aortic dissection in the German healthcare setting: a predictive study.BMJ open · 2024Article
- Trends in sex-specific differences following aortic arch repair: results from the Canadian Thoracic Aortic Collaborative.Annals of cardiothoracic surgery · 2023Article
- Management of acute aortic dissection in critical care.Journal of the Intensive Care Society · 2023Review
Corrections and comments
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Authors and funding
16 authors.
Funding
Abstract
backgroundLittle is known about variations in care and outcomes of patients undergoing surgical repair for type A aortic dissection(TAAD). We aim to investigate decade-long trends in TAAD surgical repair in England.
methodsRetrospective review of the National Adult Cardiac Surgery Audit, which prospectively collects demographic and peri‑operative information for all major adult cardiac surgery procedures performed in the UK. We identified patients undergoing surgery for TAAD from January 2009-December 2018, reviewed trends in operative frequency, patient demographics, and mortality.
findingsOver the 10-year period,3,680 TAAD patients underwent surgical repair in England. A doubling in the overall number of operations conducted in England was observed (235 cases in 2009 to 510 in 2018). Number of procedures per hospital per year also doubled(9 in 2009 to 23 in 2018). Overall, in-hospital mortality was 17.4% with a trend toward lower mortality in recent years(23% in 2009 to 14.7% in 2018). There was a significant variation in operative mortality between hospitals and surgeons. We also found that most patients presented towards the middle of the week and during winter.
interpretationSurgery is the only treatment for acute TAAD but is associated with high mortality. Prompt diagnosis and referral to a specialist center is paramount. The number of operations conducted in England has doubled in 10 years and the associated survival has improved. Variations exist in service provision with a trend towards better survival in high volume centers.
fundingBritish Heart Foundation and NIHR Biomedical Research center(University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol).
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