Key result
Concomitant CABG during emergent ATAAD surgery shows no adjusted operative mortality difference versus no CABG.
Why the study?
The study aimed to explore the impacts of concomitant CABG on operative mortality and overall mortality in patients undergoing emergent surgery for acute type A aortic dissection.
Does concomitant CABG increase operative or overall mortality in patients undergoing emergent surgery for acute type A aortic dissection?
Cohort (n=527)
No
Does concomitant CABG increase operative or overall mortality in patients undergoing emergent surgery for acute type A aortic dissection?
Absolute Event Rate: 21.1% vs 10.2%
p-value: p=0.0012
Concomitant CABG during emergent surgery for acute type A aortic dissection does not independently increase operative or overall mortality after adjusting for baseline confounders.
Concomitant CABG may not independently raise mortality after adjustment; leaves open need for randomized confirmation in acute type A dissection.
Objective The aim of this study was to explore the impacts of concomitant coronary artery bypass grafting(CABG) on operative mortality and overall mortality in patients undergoing emergent surgery for acute type A aortic dissection(ATAAD). Methods Patients undergoing emergent surgery for acute type A aortic dissection in Nanjing First Hospital from Jan 2019 to Jun 2024 were identified retrospectively. According to whether underwent concomitant CABG, patients were divided into two groups, with CABG group and without CBAG group. The outcomes were operative and overall mortality. Kaplan-Meier estimation was used to depict the survival situation. Multivariable Cox regression was built to explore the effect of concomitant CABG to overall mortality. Inverse probability weighing was used to minimize the confounder effects to outcomes. Results A total of 527 patients undergoing open aortic arch replacement for ATAAD were enrolled in this study. 57 patients underwent concomitant CABG. Operative and overall mortality were higher in concomitant CABG group (21.1%vs10.2%, P =0.0012; 22.8%vs14.9%, P =0.042). However, after inverse probability weighing, the operative and overall mortality were not significantly different between the two groups. Multivariable Cox regression analysis showed that concomitant CABG was not associated with higher all-cause death mortality. Conclusion In this study, concomitant CABG was not associated with operative and overall mortality in patients underwent emergent surgery for ATAAD.
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Fan et al. (2025) conducted a cohort in Acute type A aortic dissection (ATAAD) (n=527). Concomitant coronary artery bypass grafting (CABG) vs. Without concomitant CABG was evaluated on Operative mortality (p=0.0012). Concomitant CABG during emergent surgery for acute type A aortic dissection was associated with higher unadjusted operative mortality (21.1% vs 10.2%) but showed no significant difference after IPW.
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