title: Type A Aortic Dissection Occurring After Previous Cardiac Surgery.
abstract: BACKGROUND
  We retrospectively reviewed our experience of total arch replacement in patients undergoing repair of an ascending aortic dissection following previous cardiac surgery.
  
  
  METHODS
  Data were collected for patients with acute type A aortic dissection following previous cardiac surgery between January 2005 and December 2014. Clinical and prognostic features were retrospectively analyzed.
  
  
  RESULTS
  Twenty-eight eligible patients (nonelective: 10, elective: 18) were identified. There was a mean period of 44.5 months between the first operation and the subsequent surgery. The overall 30-day mortality rate was 21.4%; 30.0% for nonelective patients and 16.7% for elective patients. Postoperative morbidity rate was higher among nonelective patients versus elective group. During follow-up, two patients died: one from intracranial hemorrhage and the other from a noncardiac cause. One patient received endografting as a result of the true lumen being compressed by the false lumen following aortic repair.
  
  
  CONCLUSIONS
  When hemodynamically stable, patients with acute ascending aortic dissection following previous cardiac surgery may have improved outcomes if the surgery can be performed on an elective basis.
authors.affiliation: Department of Cardiothoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China.
authors.forename: Zhaohua
authors.initials: Z
authors.lastname: Yang
authors.affiliation: Department of Cardiothoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China.
authors.forename: Shouguo
authors.initials: S
authors.lastname: Yang
authors.affiliation: Department of Cardiothoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China.
authors.forename: Fanshun
authors.initials: F
authors.lastname: Wang
authors.affiliation: Department of Cardiothoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Hong
authors.affiliation: Department of Cardiothoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Lai
authors.affiliation: Department of Cardiothoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China.
authors.forename: Chunsheng
authors.initials: C
authors.lastname: Wang
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000145:classification / Q000503:physiopathology / Q000601:surgery*; D001013:Aorta, Thoracic / Q000601:surgery*; D001014:Aortic Aneurysm / Q000145:classification / Q000503:physiopathology / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D006348:Cardiac Surgical Procedures; D017558:Elective Surgical Procedures / Q000401:mortality; D005500:Follow-Up Studies; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D011183:Postoperative Complications; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome