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Easo, J; Weigang, E; Hölzl, PP; Horst, M; Hoffmann, I; Blettner, M; Dapunt, OE; GERAADA study group.
Influence of operative strategy for the aortic arch in DeBakey type I aortic dissection: analysis of the German Registry for Acute Aortic Dissection Type A.
J THORAC CARDIOVASC SURG. 2012; 144(3): 617-623. Doi: 10.1016/j.jtcvs.2011.07.066 [OPEN ACCESS]
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Co-authors Med Uni Graz: Dapunt Otto Eugen
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Abstract:: Patients treated with an extensive approach including total aortic arch replacement for acute aortic dissection type A may have a favorable long-term prognosis by treating the residual false lumen. Our goal was to analyze the operative strategy for treatment of type I DeBakey aortic dissection from the German Registry for Acute Aortic Dissection Type A (GERAADA) data. A total of 658 patients with type I DeBakey aortic dissection and entry only in the ascending aorta were identified in the GERAADA. Patients in group A underwent replacement of the ascending aorta with hemiarch replacement. Patients in group B received extensive treatment with total arch replacement or conventional or frozen elephant trunk. A total of 518 patients in group A and 140 patients in group B were treated. There was an overall 30-day mortality of 20.2% (n = 133). Group A had a slightly lower rate of mortality with 18.7% (n = 97) compared with 25.7% for group B (n = 36), but with no statistical significant difference (P = .067). The onset of new neurologic deficit (13.6% in group vs 12.5% in group B, P = .78) and new malperfusion deficit (8.4% in group A vs 10.7% in group B, P = .53) showed no statistical difference. On analysis of the GERAADA data, it seems that a more aggressive approach of aortic arch treatment can be applied without higher perioperative risk even in the onset of acute aortic dissection type A. Long-term follow-up data analysis will be necessary to offer the optimal surgical strategy for different patient groups. Copyright © 2012 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.
Find related publications in this database (using NLM MeSH Indexing): Acute Disease -; Aged -; Aneurysm, Dissecting - mortality Aneurysm, Dissecting - surgery; Aortic Aneurysm - mortality Aortic Aneurysm - surgery; Blood Vessel Prosthesis Implantation - adverse effects Blood Vessel Prosthesis Implantation - methods Blood Vessel Prosthesis Implantation - mortality; Female -; Female -; Humans -; Logistic Models -; Male -; Middle Aged -; Postoperative Complications - etiology; Registries -; Risk Assessment -; Risk Factors -; Time Factors -; Treatment Outcome -