Universität zu Köln

Merkle, Julia, Sabashnikov, Anton, Deppe, Antje Christin, Weber, Saskia, Mader, Navid, Choi, Yeong-Hoon, Liakopoulos, Oliver, Kuhn-Regnier, Ferdinand and Wahlers, Thorsten (2019). Impact of Different Aortic Entry Tear Sites on Early Outcomes and Long-Term Survival in Patients with Stanford A Acute Aortic Dissection. Thorac. Cardiovasc. Surg., 67 (5). S. 363 - 372. STUTTGART: GEORG THIEME VERLAG KG. ISSN 1439-1902

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Abstract

Background Stanford A acute aortic dissection (AAD) is a life-threatening emergency. The aim of this study was to compare the impact of three different aortic entry tear sites on early outcomes and long-term survival of patients with Stanford A AAD. Methods From January 2006 to April 2015, a total of 240 consecutive patients with diagnosed Stanford A AAD underwent emergent, isolated surgical aortic repair in our center. Patients were divided into three groups comprising isolated ascending aorta, proximal aortic arch, and distal aortic arch entry tear site and were followed up for up to 9 years. Results Thirty-day mortality as well as major cerebrovascular events were significantly different between the three groups ( p =0.007 and p =0.048, respectively). Overall cumulative short- and long-term survival of all patients revealed significant differences (Log-Rank p =0.002), whereas survival of all patients free from major cerebrovascular events was similar (Log-Rank p =0.780). Subgroup analysis of short- and long-term survival of patients showed significant differences in terms of men (Log-Rank p =0.043), women (Log-Rank p =0.004), patients over 65 years of age (Log-Rank p =0.007), and hypertensive patients (Log-Rank p =0.003). Kaplan-Meier survival estimation plots significantly showed poorest survival for distal aortic arch entry tear site group. Conclusion The location of the primary entry tear in patients with Stanford A AAD significantly influences early outcomes, short- and long-term survival of patients, whereas survival of patients free from major cerebrovascular events showed similar results among the three groups. Distal aortic entry tear site showed poorest outcomes and survival.

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 Weber, Saskia UNSPECIFIED UNSPECIFIED UNSPECIFIED Mader, Navid UNSPECIFIED UNSPECIFIED UNSPECIFIED Choi, Yeong-Hoon UNSPECIFIED UNSPECIFIED UNSPECIFIED Liakopoulos, Oliver UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhn-Regnier, Ferdinand UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahlers, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-145216
DOI:	10.1055/s-0038-1649511
Journal or Publication Title:	Thorac. Cardiovasc. Surg.
Volume:	67
Number:	5
Page Range:	S. 363 - 372
Date:	2019
Publisher:	GEORG THIEME VERLAG KG
Place of Publication:	STUTTGART
ISSN:	1439-1902
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language A DISSECTION; SURGERY; REPAIR; EXPERIENCE; MANAGEMENT Multiple languages Cardiac & Cardiovascular Systems; Respiratory System; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/14521