Comparison of Outcomes in DeBakey Type AI Versus AII Aortic Dissection

Kohl, Louis P.; Isselbacher, Eric M.; Majahalme, Nilla; Evangelista, Arturo; Russo, Mark J.; Hutchison, Stuart J.; Bossone, Eduardo; Suzuki, Toru; Pyeritz, Reed E.; Gleason, Thomas G.; Conklin, Lori D.; Montgomery, Daniel; Nienaber, Christoph; Eagle, Kim A.; Harris, Kevin M.

doi:10.1016/j.amjcard.2018.04.042

Cited by 17 publications

(17 citation statements)

References 20 publications

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“…As reported by Kohl et al, D1-AAD and D2-AAD yielded similar late survival rates for patients who survived to index hospitalization discharge [13]. Similar outcomes were observed in the present study; patients who survived to discharge in the D1 and D2 groups had comparable 5-year survival rates in both of the overall cohort and propensity-matched cohort.…”

Section: Discussionsupporting

confidence: 91%

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Surgical outcomes of DeBakey type I and type II acute aortic dissection: a propensity score-matched analysis in 599 patients

Lin

Tung

et al. 2021

J Cardiothorac Surg

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Background The DeBakey classification divides Stanford acute type A aortic dissection (ATAAD) into DeBakey type I (D1) and type II (D2) according to the extent of acute aortic dissection (AAD). This retrospective study aimed to compare the early and late outcomes of D1-AAD and D2-AAD through a propensity score-matched analysis. Methods Between January 2009 and April 2020, 599 consecutive patients underwent ATAAD repair at our institution, and were dichotomized into D1 (n = 543; 90.7%) and D2 (n = 56; 9.3%) groups. Propensity scoring was performed with a 1:1 ratio, resulting in a matched cohort of 56 patients per group. The clinical features, postoperative complications, 5-year cumulative survival and freedom from reoperation rates were compared. Results In the overall cohort, the D1 group had a lower rate of preoperative shock and more aortic arch replacement with longer cardiopulmonary bypass time. The D1 group had a higher in-hospital mortality rate than the D2 group in overall (15.8% vs 5.4%; P = 0.036) and matched cohorts (19.6% vs 5.4%; P = 0.022). For patients that survived to discharge, the D1 and D2 groups demonstrated similar 5-year survival rates in overall (77.0% vs 85.2%; P = 0.378) and matched cohorts (79.1% vs 85.2%; P = 0.425). The 5-year freedom from reoperation rates for D1 and D2 groups were 80.0% and 97.1% in overall cohort (P = 0.011), and 93.6% and 97.1% in matched cohort (P = 0.474), respectively. Conclusions Patients with D1-AAD had a higher risk of in-hospital mortality than those with D2-AAD. However, for patients who survived to discharge, the 5-year survival rates were comparable between both groups.

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Section: Discussionsupporting

confidence: 91%

“…Patients with D1-AAD were associated with inferior outcomes compared to those with D2-AAD in the previous literature [ 6 , 7 , 13 ]. However, great differences in preoperative and operative characteristics between D1-AAD and D2-AAD commonly exist because of the nature of different vascular anatomy.…”

Section: Discussionmentioning

confidence: 98%

Surgical outcomes of DeBakey type I and type II acute aortic dissection: a propensity score-matched analysis in 599 patients

Lin

Tung

et al. 2021

J Cardiothorac Surg

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“…In the literature, there are only few studies about the investigation of surgical outcomes of patients with DeBakey type I or II (3)(4)(5)(6).…”

Section: Discussionmentioning

confidence: 99%

“…It is controversial if the type or the size of aortic dissection is associated with the mortality in patients with aortic dissection type I or type II (3)(4)(5)(6). We hypothesize that the current advances in surgical techniques, circulatory management, and postoperative care improve the clinical outcome of patients with DeBakey type I and II The purpose of this study was therefore to evaluate retrospectively the effect of these parameters on the outcome in patients with aortic dissection type I and type II in a large cohort study.…”

Section: Introductionmentioning

confidence: 99%

Comparison of outcomes in DeBakey type I versus DeBakey type II aortic dissection: a 17-year single center experience

Ravesh¹,

Salem²,

Lutter³

et al. 2021

J Thorac Dis

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“…Surgery for acute Stanford Type A aortic dissection (TAAD) is associated with substantial early mortality and morbidity [ 1 , 2 ]. In these patients, surgical strategy is dictated by the extent of TAAD, the site of the intimal tear and the coexistence of malperfusion syndromes.…”

Section: Introductionmentioning

confidence: 99%

Late Outcome after Surgery for Type-A Aortic Dissection

Jormalainen

Raivio

Biancari

et al. 2020

JCM

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The aim of this study was to evaluate all-cause mortality and aortic reoperations after surgery for Stanford type A aortic dissection (TAAD). We evaluated the late outcome of patients who underwent surgery for acute TAAD from January 2005 to December 2017 at the Helsinki University Hospital, Finland. We studied 309 patients (DeBakey type I TAAD: 89.3%) who underwent repair of TAAD. Aortic root repair was performed in 94 patients (30.4%), hemiarch repair in 264 patients (85.4%) and partial/total aortic arch repair in 32 patients (10.4%). Hospital mortality was 13.6%. At 10 years, all-cause mortality was 34.9%, and the cumulative incidence of aortic reoperation or late aortic-related death was 15.6%, of any aortic reoperation 14.6%, reoperation on the aortic root 6.6%, on the aortic arch, descending thoracic and/or abdominal aorta 8.7%, on the descending thoracic and/or abdominal aorta 6.4%, and on the abdominal aorta 3.8%. At 10 years, cumulative incidence of reoperation on the distal aorta was higher in patients with a diameter of the descending thoracic aorta ≥35 mm at primary surgery (cumulative incidence in the overall series: 13.2% vs. 4.0%, SHR 3.993, 95%CI 1.316–12.120; DeBakey type I aortic dissection: 13.6% vs. 4.5%, SHR 3.610, 95%CI 1.193–10.913; patients with dissected descending thoracic aorta: 15.8% vs. 5.9%, SHR 3.211, 95%CI 1.067–9.664). In conclusion, surgical repair of TAAD limited to the aortic segments involved by the intimal tear was associated with favorable survival and a low rate of aortic reoperations. However, patients with enlarged descending thoracic aorta at primary surgery had higher risk of late reoperation. Half of the distal aortic reinterventions were performed on the abdominal aorta.

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Comparison of Outcomes in DeBakey Type AI Versus AII Aortic Dissection

Cited by 17 publications

References 20 publications

Surgical outcomes of DeBakey type I and type II acute aortic dissection: a propensity score-matched analysis in 599 patients

Surgical outcomes of DeBakey type I and type II acute aortic dissection: a propensity score-matched analysis in 599 patients

Comparison of outcomes in DeBakey type I versus DeBakey type II aortic dissection: a 17-year single center experience

Late Outcome after Surgery for Type-A Aortic Dissection

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