Performing RDAVR with the Intuity and Perceval rapid deployment valves provides comparable good clinical outcomes and valve hemodynamics, with low valve-related complication rates. The rate of pacemaker implantation was comparable for both rapid deployment valves, ranging from 8% to 13%.

OBJECTIVES The German Registry of Acute Aortic Dissection Type A (GERAADA) score to predict 30-day mortality in patients suffering from acute aortic dissection type A (AADA) was recently introduced. The aim of this study was to evaluate if the GERAADA score’s prediction corresponds with the authors’ institutional results. METHODS All consecutive AADA patients between 2010 and 2020 were included. Retrospective data collection comprised 11 preoperative parameters: age, sex, previous cardiac surgery, inotropic support at referral, resuscitation before surgery, aortic regurgitation, preoperative hemiparesis, intubation/ventilation at referral, preoperative organ malperfusion, extension of aortic dissection and location of primary entry site. Calculations of the GERAADA score were individually performed by a cardiac surgeon blinded to the study for all patients via a web-based application (https://www.dgthg.de/de/GERAADA_Score). RESULTS A total of 371 AADA patients were operated at the authors’ institution. The mean age was 62.7 ± 13.5 years and 233 (63%) were males. Prediction of 30-day mortality was accurate for the entire study cohort (actual vs predicted 30-day mortality: 15.1% vs 15.7%; P = 0.776) as well as for all 26 subgroups. In addition, preoperative resuscitation (P < 0.001), advanced age (P = 0.042) and other/unknown malperfusion (P = 0.032) were identified as independent risk factors. CONCLUSIONS The GERAADA score prediction of 30-day mortality after surgery is accurate, easily accessible due to its web-based platform and can be calculated with very basic preoperative clinical parameters. A prospective clinical trial is required to further evaluate the new GERAADA score as a useful tool to allow for improved decision-making in the emergency setting of AADA.

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Objectives Management of acute abdomen (AA) differs due to the heterogeneity of underlying pathophysiology. Complications of AA and its overall outcome after cardiac surgery are known to be associated with poor results. The aim of this retrospective analysis was to evaluate risk factors for AA in patients undergoing cardiac surgery. Methods Between December 2011 and December 2014, a total of 131 patients with AA after cardiac surgery were identified and retrospectively analyzed using our institutional database. Statistical analysis of risk factors concerning in-hospital mortality of mentioned patient cohort was performed using IBM SPSS Statistics. Results Overall in-hospital mortality was 54.2% (71/131). Analyzing in-hospital non-survivors (NS) versus inhospital survivors (S) peripheral artery disease (28.2% vs. 11.7%; p = 0.03), the need for assist device therapy (33.8% vs. 16.7%; p = 0.03) and the requirement of hemodialysis (67.6% vs. 23.3%; p \ 0.01) were significantly higher in NS. Furthermore, lactic acid values at onset of symptoms were shown to be significantly higher in NS (5.7 ± 5.7 mmol/L vs. 2.8 ± 2.9 mmol/L; p \ 0.01). Assured diagnosis of mesenterial ischemia was strongly associated with worse outcome (odds ratio 10.800, 95% confidence interval 2.003-58.224; p = 0.006). Conclusion In conclusion, in critically ill patients after performed cardiac surgery peripheral vascular disease, need for supportive hemodynamic assist device systems and occurrence of renal failure are risk factors associated with worsen outcome. Additionally, rise of lactic acid could potentially be associated with onset of intestinal malperfusion and should be taken into account in therapeutic decisions preventing fatal mesenterial ischemia.