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Low rate of reoperations after acute type A aortic dissection repair from The Nordic Consortium Registry.
Pan, Emily; Gudbjartsson, Tomas; Ahlsson, Anders; Fuglsang, Simon; Geirsson, Arnar; Hansson, Emma C; Hjortdal, Vibeke; Jeppsson, Anders; Järvelä, Kati; Mennander, Ari; Nozohoor, Shahab; Olsson, Christian; Wickbom, Anders; Zindovic, Igor; Gunn, Jarmo.
Afiliación
  • Pan E; Heart Center, Turku University Hospital, Turku, Finland; Department of Surgery, University of Turku, Turku, Finland.
  • Gudbjartsson T; Landspitali University Hospital and Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
  • Ahlsson A; Department of Cardiothoracic and Vascular Surgery, Örebro University Hospital, Orebro, Sweden; School of Health and Medicine, Orebro University, Orebro, Sweden.
  • Fuglsang S; Department of Thoracic and Cardiovascular Surgery, Aarhus University Hospital, Skejby, Denmark.
  • Geirsson A; Landspitali University Hospital and Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
  • Hansson EC; Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
  • Hjortdal V; Department of Thoracic and Cardiovascular Surgery, Aarhus University Hospital, Skejby, Denmark.
  • Jeppsson A; Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
  • Järvelä K; Heart Center, Tampere University Hospital, Tampere, Finland; University of Tampere, Tampere, Finland.
  • Mennander A; Heart Center, Tampere University Hospital, Tampere, Finland; University of Tampere, Tampere, Finland.
  • Nozohoor S; Department of Cardiothoracic Surgery, Skane University Hospital, Lund, Sweden; Clinical Sciences, Lund University, Lund, Sweden.
  • Olsson C; Department of Thoracic and Cardiovascular Surgery, Karolinska University Hospital, Stockholm, Sweden.
  • Wickbom A; Department of Cardiothoracic and Vascular Surgery, Örebro University Hospital, Orebro, Sweden; School of Health and Medicine, Orebro University, Orebro, Sweden.
  • Zindovic I; Department of Cardiothoracic Surgery, Skane University Hospital, Lund, Sweden; Clinical Sciences, Lund University, Lund, Sweden.
  • Gunn J; Heart Center, Turku University Hospital, Turku, Finland; Department of Surgery, University of Turku, Turku, Finland. Electronic address: jarmo.gunn@tyks.fi.
J Thorac Cardiovasc Surg ; 156(3): 939-948, 2018 09.
Article en En | MEDLINE | ID: mdl-29753501
OBJECTIVES: To describe the relationship between the extent of primary aortic repair and the incidence of reoperations after surgery for type A aortic dissection. METHODS: A retrospective cohort of 1159 patients treated for type A aortic dissection at eight Nordic low- to medium-sized cardiothoracic centers from 2005 to 2014. Data were gathered from patient records and national registries. Patients were separately divided into 3 groups according to the distal anastomoses technique (ascending aorta [n = 791], hemiarch [n = 247], and total arch [n = 66]), and into 2 groups for proximal repair (aortic root replacement [n = 285] and supracoronary repair [n = 832]). Freedom from reoperation was estimated with cumulative incidence survival and Fine-Gray competing risk regression model was used to identify independent risk factors for reoperation. RESULTS: The median follow-up was 2.7 years (range, 0-10 years). Altogether 51 out of 911 patients underwent reoperation. Freedom from distal reoperation at 5 years was 96.9%, with no significant difference between the groups (P = .22). Freedom from proximal reoperation at 5 years was 97.8%, with no difference between the groups (P = .84). Neither DeBakey classification nor the extent of proximal or distal repair predicted freedom from a later reoperation. The only independent risk factor associated with a later proximal reoperation was a history of connective tissue disease. CONCLUSIONS: Type A aortic dissection repair in low- to medium-volume centers was associated with a low reoperation rate and satisfactory midterm survival. The extent of the primary repair had no significant influence on reoperation rate or midterm survival.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Aneurisma de la Aorta / Disección Aórtica Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: J Thorac Cardiovasc Surg Año: 2018 Tipo del documento: Article País de afiliación: Finlandia Pais de publicación: Estados Unidos
Texto completo
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Aneurisma de la Aorta / Disección Aórtica Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: J Thorac Cardiovasc Surg Año: 2018 Tipo del documento: Article País de afiliación: Finlandia Pais de publicación: Estados Unidos