Elbayomi M, Weyand M, Pathare P, Nooh E, Harig F (2023)
Publication Type: Journal article
Publication year: 2023
Book Volume: 26
Pages Range: E164-E169
Journal Issue: 1
DOI: 10.1532/hsf.5345
Background: The optimal management strategy for acute aortic type A dissection remains controversial. Whether a limited primary (index) repair would increase the need for late aortic reintervention is still an open debate.Methods: A total of 393 consecutive adult patients with acute type A aortic dissection who underwent cardiac surgery were analyzed. Our research hypothesis was whether limited aortic index repair (i.e., isolated aorta ascending replace-ment without an open distal anastomosis with and without a concomitant aortic valve replacement, including hemiarch replacement procedure) is associated with a higher incidence of late aortic reoperation compared with extended repair (i.e., any other surgical procedure that goes beyond that limited approach).Results: Type of the initial repair had no statically sig-nificant relationship with in-hospital mortality with a P-value of 0.12, however in multivariable analysis, cross-clamp time had a statistically significant relation with mortality (P = 0.4). From the patients who survived until discharge (N = 311), 40 patients needed a reoperation on the aorta; the mean interval until reoperation was 4.5 years. The relationship between the type of the initial repair and the need for reoperation didn't reach a statically significant value (P = 0.9). In-hospitable mortality after the second operation was 10% (N = 4).Conclusion: We reached two conclusions. 1) An extended prophylactic repair in the initial operation of an acute type A aortic dissection might not lead to a lower incidence of reoperations on the aorta and could increase in-hospital mor-tality by increasing cross-clamp time, and 2) Reoperation on the aorta could be done safely with acceptable mortality outcomes.
APA:
Elbayomi, M., Weyand, M., Pathare, P., Nooh, E., & Harig, F. (2023). Single-Center Retrospective Analysis of Acute Type A Aortic Dissection Outcome and Reoperation Focusing on Extended Versus Limited Initial Repair. Heart Surgery Forum, 26(1), E164-E169. https://doi.org/10.1532/hsf.5345
MLA:
Elbayomi, Mohamed, et al. "Single-Center Retrospective Analysis of Acute Type A Aortic Dissection Outcome and Reoperation Focusing on Extended Versus Limited Initial Repair." Heart Surgery Forum 26.1 (2023): E164-E169.
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