Key result
Preoperative dialysis linked to ~67% lower 3-year survival after acute type A dissection repair.
Why the study?
There is a paucity of data describing the safety and efficacy of acute type A aortic dissection repair surgeries in dialysis patients.
Does preoperative dialysis for ESRD worsen outcomes in patients undergoing emergency repair for acute type A aortic dissection?
Cohort (n=882)
No
Does preoperative dialysis for ESRD worsen outcomes in patients undergoing emergency repair for acute type A aortic dissection?
Dialysis patients undergoing emergency repair for acute type A aortic dissection have comparable short-term outcomes but significantly worse long-term survival and higher rates of late aortic events compared to non-dialysis patients.
Dialysis patients may achieve comparable short-term ATAAD repair outcomes; leaves open whether intensified long-term surveillance improves prognosis in this small cohort.
There is a paucity of data describing the safety and efficacy of acute type A aortic dissection (ATAAD) repair surgeries in dialysis patients. Our study aimed to investigated the influence of dialysis on early and late outcomes in end-stage renal disease (ESRD) patients who received repair surgery for ATAAD. A total of 882 ATAAD patients who received emergency aortic dissection repair at our center from January 2015 to December 2019 were retrospectively screened in this study and divided into the dialysis group (n = 16) and the non-dialysis group (n = 866), depending on whether they required dialysis for preoperative ESRD. No significant difference of age, preoperative hemodynamics, organ ischemia conditions, operative variables as well as the 30-Day mortality and in-hospital complications was discovered between two groups. However, the survival rates and the proportion of late aortic event (sudden death and reoperation) free population at 1 and 3 years after surgery were significantly decreased in dialysis patients compared to non-dialysis patients. Our study indicated that the short-term surgical outcomes of ATAAD in dialysis patients were comparable to non-dialysis patient. However, the dialysis patients were associated with a worse long-term prognosis.
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Wang et al. (2022) conducted a cohort in Acute type A aortic dissection (n=882). Dialysis vs. Non-dialysis was evaluated on 3-year survival rate (p=<0.001). Preoperative dialysis in patients undergoing acute type A aortic dissection repair was associated with significantly lower 3-year survival (29.7% vs 90.1%, p<0.001) despite similar 30-day mortality.
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