title: Repair of acute type A aortic dissection: results in 100 patients.
abstract: To determine short- and long-term outcomes after repair of type A aortic dissection, we reviewed data of 100 consecutive patients (64 men; mean age, 63 ± 12.2 years) who underwent acute type A aortic dissection repair between January 2000 and June 2008. They were divided into group A, open anastomosis (circulatory arrest; n = 59) and group B, closed anastomosis (no circulatory arrest; n = 41). Aortic valve re-suspension or replacement was performed in 77 patients, aortic root replacement in 29, and aortic arch procedures in 31. The median follow-up was 2.8 years (range, 0-8.6 years). The 30-day mortality was 14%; 16.9% in group A and 9.8% in group B. None of the 23 variables analyzed to determine predictors of death or stroke was significant on multivariate analysis. Postoperatively, there was no difference between the 2 groups with respect to stroke, sepsis, renal failure, multiorgan failure, or reoperation. Overall actuarial survival at 1, 3, 5, and 8 years was not significantly different between the 2 groups. Considerable morbidity is still associated with repair of type A aortic dissection, despite a significant improvement in mortality.
authors.affiliation: Wessex Cardiothoracic Centre, Southampton University Hospitals NHS Trust, Southampton, UK. hunaid.vohra@suht.swest.nhs.uk
authors.forename: Hunaid A
authors.initials: HA
authors.lastname: Vohra
authors.forename: Amit
authors.initials: A
authors.lastname: Modi
authors.forename: Clifford W
authors.initials: CW
authors.lastname: Barlow
authors.forename: Sunil K
authors.initials: SK
authors.lastname: Ohri
authors.forename: Steve A
authors.initials: SA
authors.lastname: Livesey
authors.forename: Geoffrey M K
authors.initials: GM
authors.lastname: Tsang
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D000784:Aortic Dissection / Q000401:mortality / Q000601:surgery*; D001013:Aorta, Thoracic / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006324:Heart Arrest, Induced / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology; D014656:Vascular Surgical Procedures / Q000379:methods*