Surgical Outcomes of Type A Aortic Dissection at a Small-Volume Medical Center: Analysis according to the Extent of Surgery

Abstract

Background: Despite progress in treatment, Stanford type A aortic dissection is still a life-threatening disease. In this study, we analyzed surgical outcomes in patients with Stan-ford type A aortic dissection according to the extent of surgery at Daegu Catholic Univer-sity Medical Center.Methods: We retrospectively analyzed 98 patients with Stanford type A aortic dissection who underwent surgery at our institution between January 2008 and June 2018. Of these patients, 82 underwent limited replacement (hemi-arch or ascending aortic replacement), while 16 patients underwent total arch replacement (TAR). We analyzed in-hospital mor-tality, postoperative complications, the overall 5-year survival rate, and the 5-year aortic event-free survival rate.Results: The median follow-up time was 48 months (range, 1–128 months), with a com-pletion rate of 85.7% (n=84). The overall in-hospital mortality rate was 8.2%: 6.1% in the lim-ited replacement group and 18.8% in the TAR group (p=0.120). The overall 5-year survival rate was 78.8% in the limited replacement group and 81.3% in the TAR group (p=0.78). The overall 5-year aortic event-free survival rate was 85.3% in the limited replacement group and 88.9% in the TAR group (p=0.46).Conclusion: The extent of surgery was not related to the rates of in-hospital mortality, complications, aortic events, or survival. Although this study was conducted at a small-vol-ume center, the in-hospital mortality and 5-year survival rates were satisfactory.

Keywords

• type a aortic dissection
• postoperative complications
• survival rate