ArticleInterdisciplinary cardiovascular and thoracic surgery2025
Impact of an On-Call Specialist Aortic Rota Implementation in Acute Type a Aortic Dissection on Outcomes and Repair Complexity: A Retrospective Cohort Study.
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. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Acute Aortic Syndromes: A Call for Specialization, Centralization, and Collaboration.JACC. Case reports · 2026Article
- Comments in "Impact of an on-Call Specialist Aortic Rota Implementation in Acute Type an Aortic Dissection on Outcomes and Repair Complexity: A Retrospective Cohort Study".Interdisciplinary cardiovascular and thoracic surgery · 2026Article
- Reply to Katkuri et al.Interdisciplinary cardiovascular and thoracic surgery · 2026Article
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9 authors.
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No grant is acknowledged in the PubMed record.
Abstract
objectivesAcute Type A aortic dissection (ATAAD) repair is a high-risk procedure with significant in-hospital mortality. This study evaluates the impact of implementing an On-call Specialist Aortic Rota on ATAAD repair outcomes.
methodsRetrospective analysis of prospectively collected data for all ATAAD repairs performed in our centre between January 2015 and October 2023 (n = 406). In September 2020, an On-Call Specialist Aortic Rota was introduced, requiring surgeons to perform at least 10 major aortic cases and 4 ATAAD repairs annually. Outcomes were compared between the pre-Rota (Group A) and post-Rota (Group B) implementation groups.
resultsPreoperative characteristics were similar between groups (mean age 59.7 ± 14 years, 68% male). In multivariable analysis, rota implementation was associated with lower in-hospital mortality (adjusted OR 0.60; 95% CI, 0.36-1.00; P = .049). Unadjusted mortality was 25% pre-Rota vs 16% post-Rota (P = .033). Group B had a higher rate of aortic root replacement (44% vs 35%, P = .008), lower ascending aorta and hemiarch replacement (40% vs 53%, P = .013) and showed a trend towards more extensive distal aortic repairs: total arch replacement (27% vs 20%, P = .139) and frozen elephant trunk (20% vs 14%, P = .171). Postoperative complications, including permanent stroke (7.9% vs 9.3%, P = .250) and continuous renal replacement therapy (9.8% vs 12.3%, P = .196), were comparable between groups, while tracheostomy rates were significantly lower in Group B (5.2% vs 9.7%, P = .036).
conclusionsThe period after introducing an On-Call Specialist Aortic Rota was associated with lower in-hospital mortality (adjusted OR 0.60; 95% CI, 0.36-1.00) and accompanied by a practice-pattern shift towards more extensive repairs. Given the observational design and potential for residual confounding and calendar-time bias, these findings should be viewed as associative rather than causal and require confirmation in multicentre studies with longer follow-up. CLINICAL TRIAL REGISTRY NUMBER: CEU/2019/11118.
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