title: Long-term outcome following repair of acute type A aortic dissection after previous cardiac surgery.
abstract: We evaluated the outcome after repair for acute spontaneous type A aortic dissection in patients with previous cardiac surgery. From January 2000 to December 2009, 114 patients underwent emergency repair for acute spontaneous type A dissection at Southampton University Hospital. Eleven (median age 64 years; range 36-83 years; two females) patients (9.8%) had undergone previous cardiac surgery and were included in this study. Aortic root replacement was performed in three patients (27%), aortic arch replacement in four patients (36%) and two patients (18%) required aortic valve re-suspension. The elephant trunk operation was performed in two patients (18%). There were two hospital deaths (18%). Two patients (18%) suffered a stroke, two needed re-opening for bleeding (18%) and two patients (18%) required haemofiltration postoperatively. Median length of hospital stay was 16 days (range 6-34 days). Actuarial survival at five and eight years for redo compared to first-time surgery was 68±3.63% vs. 81±5.34% and 51±3.8% vs. 61±5.4%, respectively (P=0.365). In conclusion, acute type A aortic dissection repair in patients with previous cardiac surgery has an acceptable mortality and comparable long-term outcome to first-time surgery.
authors: Wessex Cardiothoracic Centre, Southampton University Hospitals NHS Trust, Southampton, SO16 6YD, UK.
authors: Amit
authors: A
authors: Modi
authors: Hunaid A
authors: HA
authors: Vohra
authors: Markku
authors: M
authors: Kaarne
authors: Marcus P
authors: MP
authors: Haw
authors: Clifford W
authors: CW
authors: Barlow
authors: Sunil K
authors: SK
authors: Ohri
authors: Steven A
authors: SA
authors: Livesey
authors: Geoffrey M K
authors: GM
authors: Tsang
mesh_terms: D000208:Acute Disease; D058186:Acute Kidney Injury / Q000209:etiology / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000401:mortality / Q000601:surgery*; D001014:Aortic Aneurysm / Q000401:mortality / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality; D006348:Cardiac Surgical Procedures; D016009:Chi-Square Distribution; D004739:England; D005260:Female; D006440:Hemofiltration; D017052:Hospital Mortality; D006785:Hospitals, University; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome