Refereed journal article or data article (A1)

Outcome after surgery for acute type A aortic dissection with or without primary tear resection

List of Authors: Uimonen Mikko, Olsson Christian, Jeppsson Anders, Geirsson Arnar, Chemtob Raphaelle, Khalil Ahmad, Hjortdal Vibeke, Hansson Emma C, Nozohoor Shahab, Zindovic Igor, Gunn Jarmo, Wickbom Anders, Ahlsson Anders, Gudbjartsson Tomas, Mennander Ari

Place: Elsevier

Publication year: 2021

Journal: Annals of Thoracic Surgery

eISSN: 1552-6259



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Background: The outcome in patients after surgery for acute type A aortic dissection without replacement of the part of the aorta containing the primary tear is undefined.

Methods: Data of 1122 patients who underwent surgery for acute type A aortic dissection in eight Nordic centers from Jan 2005 to Dec 2014 were retrospectively analyzed. The patients with primary tear location either unfound, unknown, not confirmed or not recorded (n=243, 21.7%) were excluded from the analysis. The patients were divided into two groups according to whether the aortic reconstruction encompassed the portion of the primary tear (TR group, n=730) or not (TNR group, n=149). The restricted mean survival time ratios adjusted for patient characteristics and surgical details between the groups were calculated for all-cause mortality and aortic reoperation-free survival. The median follow-up time was 2.57 (inter-quartile range 0.53-5.30) years.

Results: For the majority of the patients in the TR group, the primary tear was located in the ascending aorta (83.6%). The reconstruction encompassed both aortic root and the aortic arch in 7.4% in the TR group as compared with 0.7% in the TNR patients (P<0.001). There were no significant differences in all-cause mortality (adjusted restricted mean survival time ratio 1.01, 95% confidence interval 0.92-1.12, P=0.799) or reoperation-free survival (adjusted restricted mean survival time ratio 0.98, 95% confidence interval 0.95-1.02, P=0.436) between the TR group and TNR groups.

Conclusions: Primary tear resection alo

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Last updated on 2022-07-04 at 16:21