Key result
Immediate recognition and surgical repair of intraoperative iatrogenic acute type A aortic dissection resulted in a low in-hospital mortality of 9.5% and 100% survival over a median 36-month follow-up.
Why the study?
The short- and intermediate-term outcomes of immediate (on table) recognition and surgical treatment of iatrogenic acute type A aortic dissection occurring during cardiac surgery needed investigation.
Does immediate recognition and surgical repair of intraoperative iatrogenic acute type A aortic dissection improve survival in adult patients undergoing cardiac surgery?
Observational (n=21)
No
Does immediate recognition and surgical repair of intraoperative iatrogenic acute type A aortic dissection improve survival in adult patients undergoing cardiac surgery?
Immediate recognition and surgical repair of iatrogenic acute type A aortic dissection during cardiac surgery is associated with low in-hospital mortality (9.5%) and excellent intermediate-term survival.
Answers are grounded in this paper and cite their sources.
Supports immediate repair for intraoperative iatrogenic type A dissection; leaves open need for prospective multicenter validation.
Background: To investigate short- and intermediate-term outcomes of immediate (on table) recognition and surgical treatment of iatrogenic acute type A aortic dissection (ATAD) that occurred during the course of the cardiac surgical procedures. Methods: Of 23,143 adult patients undergoing cardiac surgical procedures at our institution from January 2016 to December 2020, 21 (0.09%) suffered from intraoperative iatrogenic ATAD and underwent immediate aortic repair. Their clinical characteristics, in-hospital outcomes and follow-up results were analyzed. Results: Among the 21 patients, 13 (61.9%) suffered from hypertension, and 14 (66.7%) had a dilated ascending aorta. In-hospital mortality was 9.5%, and new onset of permanent neurologic deficit was recorded in one patient. During a median follow-up of 36.0 months, all 18 follow-up patients survived without repeated surgeries. A follow-up computed tomography (CT) examination revealed a residual false lumen in the aortic arch in 3 patients and in the descending aorta in 8, with residual false lumen perfusion in one. Conclusions: Immediate recognition and surgical repair of ATAD that developed as a complication during cardiac surgical procedures are associated with low mortality and high intermediate-term survival.
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Wang et al. (2022) conducted an observational in Intraoperative iatrogenic acute type A aortic dissection (n=21). Immediate recognition and surgical repair was evaluated on In-hospital mortality. Immediate recognition and surgical repair of intraoperative iatrogenic acute type A aortic dissection resulted in a low in-hospital mortality of 9.5% and 100% survival over a median 36-month follow-up.
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