Universität zu Köln

Merkle, Julia, Sabashnikov, Anton, Deppe, Antje-Christin, Zeriouh, Mohamed, Maier, Johanna, Weber, Carolyn, Eghbalzadeh, Kaveh, Schlachtenberger, Georg ORCID: 0000-0001-7118-8432, Shostak, Olga, Djordjevic, Ilija, Kuhn, Elmar, Rahmanian, Parwis B. ORCID: 0000-0002-3978-9251, Madershahian, Navid, Rustenbach, Christian, Liakopoulos, Oliver, Choi, Yeong-Hoon, Kuhn-Regnier, Ferdinand and Wahlers, Thorsten (2018). Impact of ascending aortic, hemiarch and arch repair on early and long-term outcomes in patients with Stanford A acute aortic dissection. Ther. Adv. Cardiovasc. Dis., 12 (12). S. 327 - 341. LONDON: SAGE PUBLICATIONS LTD. ISSN 1753-9455

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Abstract

Background: Stanford A acute aortic dissection (AAD) is a life-threatening emergency associated with major morbidity and mortality. The aim of this study was to compare outcomes of three different surgical approaches in patients with Stanford A AAD. Methods: From January 2006 to March 2015 a total of 240 consecutive patients with diagnosed Stanford A AAD underwent elective, isolated surgical aortic repair in our centre. Patients were divided into three groups according to the extent of surgical repair: isolated replacement of the ascending aorta, hemiarch replacement and total arch replacement. Patients were followed up for up to 9 years. After univariate analysis multinomial logistic regression was performed for subgroup analysis. Baseline characteristics and endpoints as well as long-term survival were analysed. Results: There were no statistically significant differences among the three groups in terms of demographics and preoperative baseline and clinical characteristics. Incidence of in-hospital stroke (p = 0.034), need for reopening due to bleeding (p = 0.031) and in-hospital mortality (p = 0.017) increased significantly with the extent of the surgical approach. There was no statistical difference in terms of long-term survival (p = 0.166) among the three groups. Applying multinomial logistic regression for subgroup analysis significantly higher odds for stroke (p = 0.023), reopening for bleeding (p = 0.010) and in-hospital mortality (p = 0.009) for the arch surgery group in comparison to the ascending aorta surgery group as well as significantly higher odds for stroke (p = 0.029) for the total arch surgery group in comparison to the hemiarch surgery group were identified. Conclusions: With Stanford A AAD the incidence of perioperative complications increased significantly with the extent of the surgical approach. Subgroup analysis and long-term follow up in patients undergoing isolated ascending or hemiarch surgery showed a lower incidence of cerebrovascular events compared with surgery for total arch replacement.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Merkle, Julia UNSPECIFIED UNSPECIFIED UNSPECIFIED Sabashnikov, Anton UNSPECIFIED UNSPECIFIED UNSPECIFIED Deppe, Antje-Christin UNSPECIFIED UNSPECIFIED UNSPECIFIED Zeriouh, Mohamed UNSPECIFIED UNSPECIFIED UNSPECIFIED Maier, Johanna UNSPECIFIED UNSPECIFIED UNSPECIFIED Weber, Carolyn UNSPECIFIED UNSPECIFIED UNSPECIFIED Eghbalzadeh, Kaveh UNSPECIFIED UNSPECIFIED UNSPECIFIED Schlachtenberger, Georg UNSPECIFIED orcid.org/0000-0001-7118-8432 UNSPECIFIED Shostak, Olga UNSPECIFIED UNSPECIFIED UNSPECIFIED Djordjevic, Ilija UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhn, Elmar UNSPECIFIED UNSPECIFIED UNSPECIFIED Rahmanian, Parwis B. UNSPECIFIED orcid.org/0000-0002-3978-9251 UNSPECIFIED Madershahian, Navid UNSPECIFIED UNSPECIFIED UNSPECIFIED Rustenbach, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Liakopoulos, Oliver UNSPECIFIED UNSPECIFIED UNSPECIFIED Choi, Yeong-Hoon UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhn-Regnier, Ferdinand UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahlers, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-162514
DOI:	10.1177/1753944718801568
Journal or Publication Title:	Ther. Adv. Cardiovasc. Dis.
Volume:	12
Number:	12
Page Range:	S. 327 - 341
Date:	2018
Publisher:	SAGE PUBLICATIONS LTD
Place of Publication:	LONDON
ISSN:	1753-9455
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language TRANSIENT NEUROLOGICAL DYSFUNCTION; A DISSECTION; RISK-FACTORS; SURGICAL-MANAGEMENT; REPLACEMENT; SURGERY; STRATEGY; PREDICTORS; REGISTRY Multiple languages Cardiac & Cardiovascular Systems Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/16251