title: [Outcomes of acute type A aortic dissection repairs in Iceland].
abstract: OBJECTIVE
  Acute type A aortic dissection is a life-threatening disease associated with significant morbidity and mortality. Treatment is challenging and requires emergency surgery. This study presents for the first time the short- and long-term outcome of acute type A aortic dissection repairs in Iceland.
  
  
  METHODS
  A retrospective review of 45 patients (mean age 60.7 ± 13.9 years, 68.9% male) treated for type A aortic dissection at Landspitali University Hospital between 1992 and 2014. Data was gathered from medical records about known risk factors, presenting symptoms, type of procedure, complications and operative mortality.
  
  
  RESULTS
  Out of 45 operations the majority (73.3%) was performed in the second half of the study period. Nearly all patients presented with chest pain and 46.7% were in shock on arrival. Malperfusion syndrome was apparent in 26.7% of cases. A variety of operative methods were used, including hypothermic circulatory arrest in 31.1% of the cases and one-third of patients needed aortic root replacement. Reoperation rate for postoperative bleeding was 29.3% and perioperative stroke occurred in 14.6% of patients. The 30-day mortality rate was 22.2% (10 patients) and 5- and 10-year survival was 71.4 ± 8.2% and 65.4 ± 9.4%, respectively.
  
  
  CONCLUSIONS
  The short-term outcomes of surgical repair for acute type A aortic dissection in Iceland is comparable to neighbouring countries, including 30-day mortality and long-term survival. Complications, however, are common, especially reoperations for bleeding. 1Department of Cardiothoracic Surgery, Landspitali University Hospital, 2Faculty of Medicine, University of Iceland.
  
  
  BACKGROUND
  Aortic dissection type A, aortic aneurysm, open heart surgery, complications, operative mortality, survival. Correspondence: Arnar Geirsson, arnarge@landspitali.is.
authors: Arnar
authors: A
authors: Geirsson
authors: Inga Hlif
authors: IH
authors: Melvinsdottir
authors: Thorarinn
authors: T
authors: Arnorsson
authors: Gunnar
authors: G
authors: Myrdal
authors: Tomas
authors: T
authors: Gudbjartsson
mesh_terms: D000208:Acute Disease; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007055:Iceland; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000401:mortality / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000209:etiology / Q000401:mortality; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome