Evidence map›Paper›PMID 38768283›Full record

ArticleBJS open2024

Aortic arch surgery for DeBakey type 1 aortic dissection in patients aged 60 years or younger.

Fausto Biancari, Javier Rodriguez Lega, Giovanni Mariscalco, Sven Peterss, Joscha Buech, Antonio Fiore, Andrea Perrotti, Andreas Rukosujew, Angel G Pinto, Till Demal and 18 more

Registry-linked trialAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BJS open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04831073 (European Registry of Type A Aortic Dissection), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04831073 completednot on this map

European Registry of Type A Aortic Dissection

TypeobservationalSponsorHelsinki University Central HospitalRan2023 to 2024Enrolled3,902ConditionsType A Aortic DissectionArmsSurgery on the ascending aorta with or without repair of the aortic root and/or aortic arch
3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

28 authors.

Fausto BiancariDepartment of Medicine, South-Karelia Central Hospital, University of Helsinki, Lappeenranta, Finland.ORCID 0000-0001-5028-8186
Javier Rodriguez LegaCardiovascular Surgery Department, University Hospital Gregorio Marañón, Madrid, Spain.
Giovanni MariscalcoDepartment of Cardiac Surgery, Glenfield Hospital, Leicester, UK.
Sven PeterssDepartment of Cardiac Surgery, LMU University Hospital, Ludwig Maximilian University, Munich, Germany.ORCID 0000-0003-1880-152X
Joscha BuechDepartment of Cardiac Surgery, LMU University Hospital, Ludwig Maximilian University, Munich, Germany.ORCID 0000-0002-8749-2962
Antonio FioreDepartment of Cardiac Surgery, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris, Creteil, France.
Andrea PerrottiDepartment of Thoracic and Cardiovascular Surgery, University of Franche-Comte, Besancon, France.
Andreas RukosujewDepartment of Cardiothoracic Surgery, University Hospital Muenster, Muenster, Germany.
Angel G PintoCardiovascular Surgery Department, University Hospital Gregorio Marañón, Madrid, Spain.
Till DemalDepartment of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Germany.
Konrad WisniewskiDepartment of Cardiothoracic Surgery, University Hospital Muenster, Muenster, Germany.ORCID 0000-0002-5784-5747
Marek PolDepartment of Cardiac Surgery, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic.
Giuseppe GattiDivision of Cardiac Surgery, Cardio-thoracic and Vascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy.ORCID 0000-0002-9996-6133
Igor VendraminCardiothoracic Department, University Hospital, Udine, Italy.
Mauro RinaldiCardiac Surgery, Molinette Hospital, University of Turin, Turin, Italy.
Robert Pruna-GuillenDepartment of Cardiovascular Surgery, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain.
Dario Di PernaDepartment of Cardiac Surgery, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy, France.
Zein El-DeanDepartment of Cardiac Surgery, Glenfield Hospital, Leicester, UK.
Hiwa SherzadDepartment of Cardiac Surgery, Glenfield Hospital, Leicester, UK.
Francesco NappiDepartment of Cardiac Surgery, Centre Cardiologique du Nord de Saint-Denis, Paris, France.
Mark FieldLiverpool Centre for Cardiovascular Sciences, Liverpool Heart and Chest Hospital, Liverpool, UK.
Matteo PettinariDepartment of Cardiac Surgery, Ziekenhuis Oost Limburg, Genk, Belgium.
Mikko JormalainenHeart and Lung Center, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
Angelo M Dell'AquilaDepartment of Cardiothoracic Surgery, University Hospital Muenster, Muenster, Germany.
Francesco OnoratiDivision of Cardiac Surgery, University of Verona Medical School, Verona, Italy.ORCID 0000-0002-0879-3557
Eduard QuintanaDepartment of Cardiovascular Surgery, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain.
Tatu JuvonenHeart and Lung Center, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
Timo MäkikallioDepartment of Medicine, South-Karelia Central Hospital, University of Helsinki, Lappeenranta, Finland.

Funding

Finnish Foundation for Cardiovascular ResearchSigrid Juselius Foundation
6 · The paper itself

Abstract

backgroundExtended aortic repair is considered a key issue for the long-term durability of surgery for DeBakey type 1 aortic dissection. The risk of aortic degeneration may be higher in young patients due to their long life expectancy. The early outcome and durability of aortic surgery in these patients were investigated in the present study.

methodsThe subjects of the present analysis were patients under 60 years old who underwent surgical repair for acute DeBakey type 1 aortic dissection at 18 cardiac surgery centres across Europe between 2005 and 2021. Patients underwent ascending aortic repair or total aortic arch repair using the conventional technique or the frozen elephant trunk technique. The primary outcome was 5-year cumulative incidence of reoperation on the distal aorta.

resultsOverall, 915 patients underwent surgical ascending aortic repair and 284 patients underwent surgical total aortic arch repair. The frozen elephant trunk procedure was performed in 128 patients. Among 245 propensity score-matched pairs, total aortic arch repair did not decrease the rate of distal aortic reoperation compared to ascending aortic repair (5-year cumulative incidence, 6.7% versus 6.7%, subdistributional hazard ratio 1.127, 95% c.i. 0.523 to 2.427). Total aortic arch repair increased the incidence of postoperative stroke/global brain ischaemia (25.7% versus 18.4%, P = 0.050) and dialysis (19.6% versus 12.7%, P = 0.003). Five-year mortality was comparable after ascending aortic repair and total aortic arch repair (22.8% versus 27.3%, P = 0.172).

conclusionsIn patients under 60 years old with DeBakey type 1 aortic dissection, total aortic arch replacement compared with ascending aortic repair did not reduce the incidence of distal aortic operations at 5 years. When feasible, ascending aortic repair for DeBakey type 1 aortic dissection is associated with satisfactory early and mid-term outcomes.

trial registrationClinicalTrials.gov Identifier: NCT04831073.

Indexed as

Aorta, ThoracicAortic DissectionBlood Vessel Prosthesis ImplantationPostoperative ComplicationsReoperationAdultAortic Aneurysm, ThoracicEuropeFemaleHumansMaleMiddle AgedPropensity ScoreRetrospective StudiesTreatment Outcome

Identifiers

PMID38768283
PMCPMC11104530

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