Evidence map›Paper›PMID 39913388›Full record

ArticleInterdisciplinary cardiovascular and thoracic surgery2025

Survival outcomes after surgery for type A aortic dissection: a contemporary Dutch nationwide registry study.

Patrick T Timmermans, Bart J J Velders, Rolf H H Groenwold, Roemer J Vos, Maaike M Roefs, Jerry Braun, Robert J M Klautz, Gianclaudio Mecozzi, Jesper Hjortnaes, Cardiothoracic Surgery Registration Committee and the Aortic Surgery Work Group of the Netherlands Heart Registration

Erratum issuedAbstract read
In one paragraph

Article in Interdisciplinary cardiovascular and thoracic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Mortality rates and causes of death after cardiac interventions: real-world short- and long-term insights from the Netherlands.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2026
    Article
  2. Surgery for acute type A aortic dissection.Interdisciplinary cardiovascular and thoracic surgery · 2025
    Article
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Patrick T TimmermansDepartment of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, Netherlands.
Bart J J VeldersDepartment of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, Netherlands.ORCID 0000-0002-3999-4220
Rolf H H GroenwoldDepartment of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands.ORCID 0000-0001-9238-6999
Roemer J VosDepartment of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, Netherlands.ORCID 0000-0002-2511-988X
Maaike M RoefsNetherlands Heart Registration, Utrecht, Netherlands.
Jerry BraunDepartment of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, Netherlands.ORCID 0000-0002-4504-6235
Robert J M KlautzDepartment of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, Netherlands.ORCID 0000-0002-6507-3855
Gianclaudio MecozziDepartment of Cardiothoracic Surgery, University Medical Center Groningen, Groningen, Netherlands.
Jesper HjortnaesDepartment of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, Netherlands.ORCID 0000-0002-6722-918X
Cardiothoracic Surgery Registration Committee and the Aortic Surgery Work Group of the Netherlands Heart Registration

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo describe the nationwide survival outcomes after surgery for type A aortic dissection.

methodsAll patients who underwent surgery for type A aortic dissection in the Netherlands between 2018 and 2021 were identified in the Netherlands Heart Registration (NHR) database. The NHR data were linked to lifelong survival data from Statistics Netherlands (98% match). Time trends for in-hospital and mid-term mortality were described, and age- and sex-adjusted regression analysis was performed. The cause and location of death were reported and stratified according to survival time intervals.

resultsThe study population consisted of 1317 patients with a mean age of 63.1 years (11.8). The number of surgeries increased from 284 in 2018 to 375 in 2021. The surgery included the ascending aorta in 99%, aortic arch in 73%, aortic root in 32.5% and the descending aorta in 5% of cases. In-hospital mortality decreased from 20.4% in 2018 to 13.9% (95% CI: [10.4%, 17.4%]) in 2021. A total of 318 deaths were recorded, and the majority (70%) of patients died from the consequences of their dissection. However, among 365-day survivors, only 14% died related to their dissection, while 37% of deaths were related to cardiovascular disease and 17% to cancer. The majority (84%) of patients died in the hospital, but deaths after 365 days occurred most frequently (37%) at home.

conclusionsOver the recent years, the number of surgeries for type A dissections in the Netherlands has increased, and in-hospital mortality has decreased. For patients surviving 1 year after surgery, the main cause of death was not dissection, but other causes such as cardiovascular disease or cancer.

Indexed as

Aortic AneurysmAortic DissectionAgedFemaleHospital MortalityHumansMaleMiddle AgedNetherlandsRegistriesRisk AssessmentRisk FactorsTime FactorsTreatment Outcomecause of deathnationwide registrythe Netherlandstype A aortic dissection

Identifiers

PMID39913388
PMCPMC11893151

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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.