Evidence map›Paper›PMID 40071739›Full record

ArticleBJS open2025

Extent of surgical repair and outcomes after surgery for type A aortic dissection.

Fausto Biancari, Daniele Fileccia, Luisa Ferrante, Timo Mäkikallio, Tatu Juvonen, Mikko Jormalainen, Giovanni Mariscalco, Zein El-Dean, Matteo Pettinari, Javier Rodriguez Lega and 25 more

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

Article in BJS open, 2025. 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, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–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 synthesis or guideline pooled it.

  1. Pooled it
  2. From survival to lifelong care: The role of patient organisations in aortic dissection.American heart journal plus : cardiology research and practice · 2026
    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

35 authors.

Fausto BiancariDepartment of Cardiovascular Surgery, Centro Cardiologico Monzino IRCCS, Milan, Italy.ORCID 0000-0001-5028-8186
Daniele FilecciaDepartment of Cardiovascular Surgery, Centro Cardiologico Monzino IRCCS, Milan, Italy.ORCID 0000-0002-3098-6611
Luisa FerranteCardiac Surgery, Molinette Hospital, University of Turin, Turin, Italy.
Timo MäkikallioDepartment of Medicine, South-Karelia Central Hospital, University of Helsinki, Lappeenranta, Finland.
Tatu JuvonenHeart and Lung Center, Helsinki University Hospital, University of Helsinki, Helsinki, and Faculty of Medicine, University of Oulu, Oulu, Finland.
Mikko JormalainenHeart and Lung Center, Helsinki University Hospital, University of Helsinki, Helsinki, and Faculty of Medicine, University of Oulu, Oulu, Finland.
Giovanni MariscalcoDepartment of Cardiac Surgery, Glenfield Hospital, Leicester, UK.
Zein El-DeanDepartment of Cardiac Surgery, Glenfield Hospital, Leicester, UK.
Matteo PettinariDepartment of Cardiac Surgery, Ziekenhuis Oost Limburg, Genk, Belgium.
Javier Rodriguez LegaCardiovascular Surgery Department, University Hospital Gregorio Marañón, Madrid, Spain.
Angel G PintoCardiovascular Surgery Department, University Hospital Gregorio Marañón, Madrid, Spain.
Andrea PerrottiDepartment of Thoracic and Cardiovascular Surgery, University of Franche-Comte, Besancon, France.
Francesco OnoratiDivision of Cardiac Surgery, University of Verona Medical School, Verona, Italy.ORCID 0000-0002-0879-3557
Konrad WisniewskiDepartment of Cardiothoracic Surgery, University Hospital Muenster, Muenster, Germany.ORCID 0000-0002-5784-5747
Till DemalDepartment of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Germany.
Petr KacerDepartment of Cardiac Surgery, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic.
Jan RocekDepartment of Cardiac Surgery, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic.
Dario Di PernaDepartment of Cardiac Surgery, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy, France.
Igor VendraminCardiothoracic Department, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy.
Daniela PianiCardiothoracic Department, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy.ORCID 0000-0001-9959-167X
Mauro RinaldiCardiac Surgery, Molinette Hospital, University of Turin, Turin, Italy.
Eduard QuintanaDepartment of Cardiovascular Surgery, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain.
Robert Pruna-GuillenDepartment of Cardiovascular Surgery, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain.
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
Caroline RadnerDepartment of Cardiac Surgery, LMU University Hospital, Ludwig Maximilian University, Munich, Germany.ORCID 0000-0002-0782-1456
Manoj KuduvalliLiverpool Centre for Cardiovascular Sciences, Liverpool Heart and Chest Hospital, Liverpool, UK.
Amer HarkyLiverpool Centre for Cardiovascular Sciences, Liverpool Heart and Chest Hospital, Liverpool, UK.
Antonio FioreDepartment of Cardiac Surgery, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France.
Michele D'AlonzoDepartment of Cardiac Surgery, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France.ORCID 0000-0002-3971-4145
Angelo M Dell'AquilaDepartment of Cardiothoracic Surgery, University Hospital Muenster, Muenster, Germany.
Giuseppe GattiDivision of Cardiac Surgery, Cardio-thoracic and Vascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy.ORCID 0000-0002-9996-6133
Lenard ConradiDepartment of Cardiac Surgery, Cologne University Hospital, Cologne, Germany.
Andrea BallottaDepartment of Cardiovascular Surgery, Centro Cardiologico Monzino IRCCS, Milan, Italy.
Mark FieldLiverpool Centre for Cardiovascular Sciences, Liverpool Heart and Chest Hospital, Liverpool, UK.

Funding

Italian Ministry of Health
6 · The paper itself

Abstract

backgroundAcute Stanford type A aortic dissection is a severe emergency condition that, if left untreated, is associated with a high mortality rate. The extent of surgical repair may impact the outcomes of these patients.

methodPatients operated for acute type A aortic dissection from a multicentre European registry were included. Patients were categorized based on the following types of surgical intervention: isolated ascending aortic replacement, ascending aortic replacement with concomitant aortic valve replacement, aortic root replacement, partial or total arch replacement, and partial or total arch replacement with concomitant aortic root replacement. The primary outcome was mortality rate, both in-hospital and at 10 years. Secondary outcomes were acute kidney injury requiring dialysis, neurological complications, a composite endpoint including in-hospital death, neurological complications and/or dialysis, and proximal endovascular or surgical aortic re-operations at 10 years.

results3702 patients were included. The adjusted risk of in-hospital mortality was higher in all subsets of patients compared to those who underwent isolated ascending aortic replacement. The adjusted rates of in-hospital mortality ranged from 16.4% (95% c.i. 15.3 to 17.4) among patients who underwent isolated ascending aortic replacement to 27.7% (95% c.i. 23.3 to 31.2) among those who underwent aortic arch and concomitant aortic root replacement. The adjusted risks of neurological complications, renal replacement therapy and of the composite endpoint were significantly higher in patients who underwent partial/total aortic arch replacement. The adjusted risk estimates of 10-year mortality rate were markedly higher in patients who underwent partial/total aortic arch replacement with or without concomitant aortic root replacement. Extensive aortic repair did not significantly reduce the risk of distal or proximal aortic reoperations.

conclusionThese findings suggest that, when feasible, limiting the extent of aortic replacement for acute type A aortic dissection may be beneficial in reducing mortality rate and major complications both in the short and long term.

trial registrationClinicalTrials.gov identifier: NCT04831073.

Indexed as

Aortic DissectionBlood Vessel Prosthesis ImplantationPostoperative ComplicationsAcute Kidney InjuryAgedEuropeFemaleHospital MortalityHumansMaleMiddle AgedRegistriesReoperationTreatment Outcome

Identifiers

PMID40071739
PMCPMC11897881

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Registered trials

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.