Key result
Specialized aortic teams linked to ~77% fewer adverse outcomes in acute type A dissection.
Why the study?
The impact of surgical experience on outcomes after acute type A aortic dissection repair was evaluated to understand predictors of adverse surgical outcomes.
Does surgery performed by highly specialized aortic surgeons reduce adverse outcomes in patients with acute type A aortic dissection?
Population
162 consecutive patients with acute type A aortic dissection, mean age 63 ± 14 years
Comparison
Surgery by specialized aortic team surgeons vs surgery by experienced attending cardiac surgeons not on the aortic team
Design
Prospective data collection with retrospective uni- and multivariate cohort analysis
Follow-up
90 days
Authors
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Supports specialized aortic teams; hypothesis-generating and requires prospective validation before practice change.
Cohort (n=162)
Does surgery performed by highly specialized aortic surgeons reduce adverse outcomes in patients with acute type A aortic dissection?
Odds Ratio: 14.1 (95% CI 3.5–55.6)
Absolute Event Rate: 8% vs 34.5%
p-value: p=<0.0001
Surgery for acute type A aortic dissection performed by highly specialized aortic teams significantly reduces adverse outcomes and mortality compared to procedures performed by general cardiac surgeons.
Lenos et al. (2014) conducted a cohort in Acute type A aortic dissection (n=162). Surgery performed by the aortic team (AT) surgeons vs. Surgery performed by surgeons not on the AT (Group No-AT) was evaluated on Surgical adverse outcome (AO) containing in-hospital and/or 90-day mortality and new permanent neurological and organ dysfunctions (OR 14.1, 95% CI 3.5-55.6, p=<0.0001). Surgery for acute type A aortic dissection performed by a specialized aortic team significantly reduced adverse outcomes compared to non-team surgeons (8.0% vs 34.5%; P<0.0001).
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