Evidence map›Paper›PMID 38688455›Full record

ArticleInterdisciplinary cardiovascular and thoracic surgery2024

Indications and outcomes of second aortic procedures after acute type A dissection repair.

Mohammed Morjan, Carlos-A Mestres, Vedran Savic, Mustafa Gerçek, Mathias Van Hemelrijck, Juri Sromicki, Omer Dzemali, Diana Reser

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Article in Interdisciplinary cardiovascular and thoracic surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Mohammed MorjanDepartment of Cardiac Surgery, University Hospital Zürich, Zürich, Switzerland.ORCID 0000-0001-9529-7094
Carlos-A MestresDepartment of Cardiac Surgery, University Hospital Zürich, Zürich, Switzerland.
Vedran SavicDepartment of Cardiac Surgery, University Hospital Zürich, Zürich, Switzerland.ORCID 0000-0001-8335-5517
Mustafa GerçekClinic for Cardiac Surgery and Pediatric Cardiac Surgery, Heart Center Duisburg, Duisburg, Germany.ORCID 0000-0002-6751-4650
Mathias Van HemelrijckDepartment of Cardiac Surgery, University Hospital Zürich, Zürich, Switzerland.ORCID 0000-0002-0191-757X
Juri SromickiDepartment of Cardiac Surgery, University Hospital Zürich, Zürich, Switzerland.ORCID 0000-0001-9964-7733
Omer DzemaliDepartment of Cardiac Surgery, University Hospital Zürich, Zürich, Switzerland.
Diana ReserDepartment of Cardiac Surgery, University Hospital Zürich, Zürich, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesAortic arch or aortic root replacement is not performed in all cases of acute type A aortic dissection (ATAD), and a second aortic procedure will become necessary over time for some patients. Indications and outcomes, of second aortic procedures have not been studied extensively.

methodsCharacteristics and in-hospital outcomes of all patients undergoing surgical repair for type A acute aortic dissection were analysed and patients needing second aortic procedure during follow-up were identified. The latter group was divided in 2 subgroups: on-pump includes patients operated on using cardiopulmonary bypass and off-pump without cardiopulmonary bypass.

resultsA total of 638 patients underwent surgery for ATAD; 8% required a second aortic procedure. The most frequent indication for the second aortic procedure was dehiscence of suture lines (44%), followed by arch dilatation (24%). In-hospital mortality was 12%. Isolated ascending aorta replacement at the first surgery was associated with higher incidence of second aortic procedure (P = 0.006). Most patients in the on-pump group underwent a proximal reoperation (75%), with a mortality rate of 14.2%. In-hospital mortality of patients in the off-pump group was 7.7%. Long-term survival analysis showed no difference between groups (P = 0,526), Off-pump patients have greater likelihood of a second intervention during follow-up (P  = 0.004).

conclusionsExtended aortic root surgery and customized aortic arch repair in ATAD could be reasonable to reduce the incidence and mortality of high-risk second aortic procedures.

Indexed as

Acute aortic dissectionRe-do surgery

Identifiers

PMID38688455
PMCPMC11090986

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.