Analysis of early and long-term outcomes of acute type A aortic dissection according to the new international aortic arch surgery study group recommendations.

Heart and vessels

PubMedID: 26577993

Colli A, Carrozzini M, Galuppo M, Comisso M, Toto F, Gregori D, Gerosa G. Analysis of early and long-term outcomes of acute type A aortic dissection according to the new international aortic arch surgery study group recommendations. Heart Vessels. 2016;.
To evaluate predictors of early and long-term outcomes of surgical repair of acute Type A aortic dissection. Retrospective single-centre study evaluating patients surgically treated between 1998 and 2013. CLINICAL
follow-up was performed.Complications were classified according to the International Aortic Arch Surgery Study Group recommendations. Statistical analysis included univariate and multivariate analysis of preoperative and operative data. One hundred eighty-five patients were evaluated. The follow-up was complete for 180 patients (97 %). Mean age was 63 years, 82 % had a DeBakey type I aortic dissection, 18 % a type II. Eleven patients (6 %) died intraoperatively, 119 of the remaining (68 %) had postoperative complications. Thirty-day mortality was 21 % (38 patients). Average ICU and hospital stay were 6 and 14 days, respectively. During a mean follow-up time of 6 ± 4 years we observed 44 deaths (31 %). Twenty patients (14 %) needed late thoracic aorta reoperation.

RESULTS
from the multivariate analysis are as follows.Thirty-day mortality was associated with abdominal pain at presentation (p < 0. 01). The incidence of postoperative complications was related to older age at intervention (p < 0. 01) and longer cross-clamp time (p < 0. 01). Mortality at follow-up was significantly increased by older age at intervention (p < 0. 01), with a logarithmic growth after 60 years, female sex (p < 0. 01), preoperative limb ischemia (p = 0. 02) and DHCA (p < 0. 01). The surgical results of type A aortic dissection are affected by age at intervention with a logarithmic increase of late mortality in patients older than 60 years.