One‐Year Functional Outcome of Patients After Surgery for Acute Stanford Type A Aortic Dissection

Background Our aim was to report the functional outcome of Stanford type A aortic dissection (TAAD) after 1 year as well as morbidity and mortality. Methods and Results This is a retrospective analysis including 642 patients with TAAD from January 2005 to December 2021. Mean age at TAAD was 62 years (95% CI, 61–63), and 30% of the population were women. One year after surgery for TAAD, 75% of patients were living at home with New York Heart Association functional class I. No patients were observed with New York Heart Association functional class IV. Less than 2% resided in an assisted‐living facility. Eighty‐five percent of nonretired patients had returned to work. Two hundred twelve (33%) patients were retired after 1 year at a mean age of 73 years (95% CI, 72–74). Stroke (defined as any kind of neurological symptoms) occurred in 148 (23%) patients and was the cause of death in 33 patients. Of the remaining patients with stroke, 115 (30%) had no residual limitations 1 year after TAAD. The cross‐clamp time was significantly higher in patients with stroke (98 minutes [95% CI, 94.0–101.1] in patients without stroke versus 106 minutes [95% CI, 98.5–114.1] in patients with stroke; P =0.026). Sixty‐nine percent of patients with stroke lived at home, 28% lived at home with support, and 3% lived in an assisted‐living facility. One year after stroke, 77% of the patients achieved a modified Rankin Scale score ≤2, whereas no patient had a modified Rankin Scale score of 5. There was no significant correlation between sex and recovery rate ( P =0.48). However, experiencing a stroke significantly increased the likelihood of residing in an assisted‐living facility or receiving support at home 1 year after TAAD (odds ratio, 9.46 [95% CI, 5.06–17.70]; P <0.001). Thirty‐day mortality was 11.8%, and 92 patients (14%) died within the first year after TAAD. There was no significant sex difference in mortality ( P =0.101). Conclusions One year after surgery for Stanford acute type A aortic dissection, almost 3 out of 4 patients lived unassisted at home. Stroke survivors have a favorable outcome, with the majority having mild or no residual neurological deficits at 1 year.