Differential aspects of ascending thoracic aortic dissection and its treatment: the North American experience

Abstract

Acute type A aortic dissection is a deadly disease with significant morbidity and mortality. We describe the differential aspects of the disease and the North American experience with its treatment.

Regional Practice Patterns and Outcomes of Surgery for Acute Type A Aortic Dissection

“…The current literature is replete with contemporary outcomes from high volume hospitals or consortiums of aortic centers reporting improving outcomes with mortalities of 5–19% (3–5, 7, 9, 16, 17). These analyses suffer from the simple fact that their aortic teams, high volume aortic surgeons, and surgical and intensive care infrastructure may not be representative of the resources available to a majority of patients suffering TAAD.…”

Target mortality for repair of acute type A dissection

“…However, this early mortality rate is comparable to other registries published during the past decade; for instance, the International Registry of Acute Aortic Dissection study (18%), 3 the registries from Sweden (22.4%), Taiwan (19.6%), the United Kingdom (18.3%), Germany (16.9%), and the United States (21.6%). [3][4][5] There are exceptions, of course, with selected individual surgeons and a few high volume centers publishing single-digit outcomes. From a patient and commissioning perspective, outcomes in these areas depend on geographic location and the vagaries of an on-call system.…”

Acute type I aortic dissection with or without antegrade stent delivery: Mid-term outcomes

“…Despite advancements in cardiac surgery, acute proximal ascending aortic dissection (DeBakey type I or Stanford type A aortic dissection) continues to be a challenging problem associated with significant mortality and morbidity, as shown in large registries and at specialized centers. [1][2][3][4][5][6][7][8][9] During surgical treatment of acute type A or type I aortic dissection, the main goals are to keep the patient alive and prevent subsequent operations in the proximal aorta and in the descending and thoracoabdominal aorta.…”