ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Stefano Pansini
Esmeralda Pompei
Francesco Parisi
Gianluca Bardi
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Pansini, S.
Right arrow Articles by di Summa, M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Pansini, S.
Right arrow Articles by di Summa, M.

Ann Thorac Surg 1998;66:779-784
© 1998 The Society of Thoracic Surgeons

Original articles: Cardiovascular

Early and late risk factors in surgical treatment of acute type A aortic dissection

Stefano Pansini, MDa, Pier Vincenzo Gagliardotto, MDa, Esmeralda Pompei, MDa, Francesco Parisi, MDa, Gianluca Bardi, MDa, Enzo Castenetto, MDa, Fulvio Orzan, MDb, Michele di Summa, MDa

a Department of Cardiac Surgery, University of Torino, Torino, Italy
b Department of Cardiology, University of Torino, Torino, Italy

Accepted for publication April 6, 1998.

Address reprint requests to Dr Pansini, Via Vittorio Veneto 25, 10028 Trofarello, (TO), Italy

Background. Morbidity and mortality of emergency repair of type A dissecting aneurysms of the aorta are high. This is an attempt to investigate the risk determinants of early and late results.

Methods. A series of preoperative and operative variables were retrospectively collected from the clinical records of 291 patients operated on between January 1, 1979, and December 31, 1995. Risk factors for surgical death were investigated with univariate analysis and stepwise logistic regression. Follow-up was conducted between December 1995 and February 1996. Analysis of late results was conducted by means of actuarial survival curves (life method). After removing the surgical deaths, risk factors for late deaths were analyzed by a Cox model.

Results. The in-hospital mortality rate was 36.1%. Significant independent determinants of operative or early death were preoperative shock, preoperative neurologic impairment, operation before 1986, perioperative bleeding, and prolonged clamping time. The 10-year survival rate was 36.9% ± 4.4%. Twenty-six patients required repeat operation. The long-term prognosis was significantly worse in patients who needed reoperation.

Conclusions. Growing awareness of this disease and quicker diagnosis have increased the number of patients with acute dissection of the ascending aorta who are taken early to operation. This new challenge must be met by better preoperative support and intraoperative monitoring, and by surgical techniques that focus on lowering the rate of late complications, for which lifelong follow-up must be provided.




This article has been cited by other articles:


Home page
 Eur. J. Cardiothorac. Surg.Home page
C.-B. Kan, R.-Y. Chang, and J.-P. Chang
Optimal initial treatment and clinical outcome of type A aortic intramural hematoma: a clinical review
Eur. J. Cardiothorac. Surg., June 1, 2008; 33(6): 1002 - 1006.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
A. Geirsson, J. E. Bavaria, D. Swarr, M. G. Keane, Y. J. Woo, W. Y. Szeto, and A. Pochettino
Fate of the Residual Distal and Proximal Aorta After Acute Type A Dissection Repair Using a Contemporary Surgical Reconstruction Algorithm
Ann. Thorac. Surg., December 1, 2007; 84(6): 1955 - 1964.
[Abstract] [Full Text] [PDF]

Home page
 ICVTSHome page
R. Coppola, R. Bonifazi, M. Gucciardo, and P. Pantaleo
Ruptured aortic arch aneurysm: transposition of aortic arch branches after insertion of thoracic endovascular stent with extra-anatomic brain perfusion
Interactive CardioVascular and Thoracic Surgery, June 1, 2007; 6(3): 376 - 378.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
T. Nakajima, K. Kawazoe, T. Kataoka, H. Kin, T. Kazui, H. Okabayashi, and H. Niinuma
Midterm Results of Aortic Repair Using a Fabric Neomedia and Fibrin Glue for Type A Acute Aortic Dissection
Ann. Thorac. Surg., May 1, 2007; 83(5): 1615 - 1620.
[Abstract] [Full Text] [PDF]

Home page
 HeartHome page
H. Ince and C. A Nienaber
Diagnosis and management of patients with aortic dissection
Heart, February 1, 2007; 93(2): 266 - 270.
[Full Text] [PDF]

Home page
 StrokeHome page
C. Gaul, W. Dietrich, I. Friedrich, J. Sirch, and F. J. Erbguth
Neurological Symptoms in Type A Aortic Dissections
Stroke, February 1, 2007; 38(2): 292 - 297.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
J. C. Halstead, M. Meier, C. Etz, D. Spielvogel, C. Bodian, M. Wurm, R. Shahani, and R. B. Griepp
The fate of the distal aorta after repair of acute type A aortic dissection
J. Thorac. Cardiovasc. Surg., January 1, 2007; 133(1): 127 - 135.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
T. T. Tsai, A. Evangelista, C. A. Nienaber, S. Trimarchi, U. Sechtem, R. Fattori, T. Myrmel, L. Pape, J. V. Cooper, D. E. Smith, et al.
Long-Term Survival in Patients Presenting With Type A Acute Aortic Dissection: Insights from the International Registry of Acute Aortic Dissection (IRAD)
Circulation, July 4, 2006; 114(1_suppl): I-350 - I-356.
[Abstract] [Full Text] [PDF]

Home page
 Canadian J. AnesthesiaHome page
J. Ballen, M. Raabe, and B. Muirhead
Aortic dissection and hypothermic arrest in a Jehovah's Witness patient: a case for recombinant factor VIIa?: [Dissection aortique et asystolie sous hypothermie chez un Temoin de Jehovah : un cas pour le facteur VIIa recombinant ?].
Can J Anesth, April 1, 2006; 53(4): 353 - 356.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
T. T. Tsai, C. A. Nienaber, and K. A. Eagle
Acute Aortic Syndromes
Circulation, December 13, 2005; 112(24): 3802 - 3813.
[Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
M. E. S.H. Tan, W. J. Morshuis, K. M.E. Dossche, J. C. Kelder, F. G.J. Waanders, and M. A.A.M. Schepens
Long-Term Results After 27 Years of Surgical Treatment of Acute Type A Aortic Dissection
Ann. Thorac. Surg., August 1, 2005; 80(2): 523 - 529.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
G. Sakaguchi, T. Komiya, N. Tamura, S. Obata, S. Masuyama, C. Kimura, and T. Kobayashi
Cerebral malperfusion in acute type A dissection: Direct innominate artery cannulation
J. Thorac. Cardiovasc. Surg., May 1, 2005; 129(5): 1190 - 1191.
[Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
S. Westaby
Editorial comment
Eur. J. Cardiothorac. Surg., April 1, 2005; 27(4): 632 - 633.
[Full Text] [PDF]

Home page
 Eur Heart JHome page
B. Chiappini, M. Schepens, E. Tan, A. D. Amore, W. Morshuis, K. Dossche, M. Bergonzini, N. Camurri, L. B. Reggiani, G. Marinelli, et al.
Early and late outcomes of acute type A aortic dissection: analysis of risk factors in 487 consecutive patients
Eur. Heart J., January 2, 2005; 26(2): 180 - 186.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
S. Trimarchi, C. A. Nienaber, V. Rampoldi, T. Myrmel, T. Suzuki, R. H. Mehta, E. Bossone, J. V. Cooper, D. E. Smith, L. Menicanti, et al.
Contemporary results of surgery in acute type A aortic dissection: The International Registry of Acute Aortic Dissection experience
J. Thorac. Cardiovasc. Surg., January 1, 2005; 129(1): 112 - 122.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
K. Kallenbach, T. Oelze, R. Salcher, C. Hagl, M. Karck, R. G. Leyh, and A. Haverich
Evolving Strategies for Treatment of Acute Aortic Dissection Type A
Circulation, September 14, 2004; 110(11_suppl_1): II-243 - II-249.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
F. F. Immer, C. Lippeck, H. Barmettler, P. A. Berdat, F. S. Eckstein, B. Kipfer, H. Saner, J. Schmidli, and T. P. Carrel
Improvement of Quality of Life After Surgery on the Thoracic Aorta: Effect of Antegrade Cerebral Perfusion and Short Duration of Deep Hypothermic Circulatory Arrest
Circulation, September 14, 2004; 110(11_suppl_1): II-250 - II-255.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
B. Chiappini, M. E. Tan, W. Morshuis, H. Kelder, K. Dossche, and M. Schepens
Surgery for acute type a aortic dissection: is advanced age a contraindication?
Ann. Thorac. Surg., August 1, 2004; 78(2): 585 - 590.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
K. Kallenbach, R.G. Leyh, R. Salcher, M. Karck, C. Hagl, and A. Haverich
Acute aortic dissection versus aortic root aneurysm: comparison of indications for valve sparing aortic root reconstruction
Eur. J. Cardiothorac. Surg., May 1, 2004; 25(5): 663 - 670.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
R. A. Hopkins
Aortic valve leaflet sparing and salvage surgery: evolution of techniques for aortic root reconstruction
Eur. J. Cardiothorac. Surg., December 1, 2003; 24(6): 886 - 897.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
T. Suzuki, R. H. Mehta, H. Ince, R. Nagai, Y. Sakomura, F. Weber, T. Sumiyoshi, E. Bossone, S. Trimarchi, J. V. Cooper, et al.
Clinical Profiles and Outcomes of Acute Type B Aortic Dissection in the Current Era: Lessons From the International Registry of Aortic Dissection (IRAD)
Circulation, September 9, 2003; 108(90101): II-312 - 317.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
M. Tanaka, K. Kawahito, H. Adachi, and T. Ino
Platelet dysfunction in acute type A aortic dissection evaluated by the laser light-scattering method
J. Thorac. Cardiovasc. Surg., September 1, 2003; 126(3): 837 - 841.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
N. Motoyoshi, Y. Moizumi, T. Komatsu, and K. Tabayashi
Intramural hematoma and dissection involving ascending aorta: the clinical features and prognosis
Eur. J. Cardiothorac. Surg., August 1, 2003; 24(2): 237 - 242.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
K. Kallenbach, C. Hagl, T. Walles, R. G. Leyh, K. Pethig, A. Haverich, and W. Harringer
Results of valve-sparing aortic root reconstruction in 158 consecutive patients
Ann. Thorac. Surg., December 1, 2002; 74(6): 2026 - 2033.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
D. Roux, L. Brouchet, H. Rousseau, T. Elghobary, Y. Glock, and G. Fournial
Treatment of a fistula at the distal anastomosis after Bentall operation with endoluminal covered stent
Ann. Thorac. Surg., December 1, 2002; 74(6): 2189 - 2190.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
T. Kazui, K. Yamashita, N. Washiyama, H. Terada, A. H. M. Bashar, T. Suzuki, and K. Ohkura
Impact of an aggressive surgical approach on surgical outcome in type A aortic dissection
Ann. Thorac. Surg., November 1, 2002; 74(5): S1844 - 1847.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
D. T. Lai, R. C. Robbins, R. S. Mitchell, K. A. Moore, P. E. Oyer, N. E. Shumway, B. A. Reitz, and D. C. Miller
Does Profound Hypothermic Circulatory Arrest Improve Survival in Patients With Acute Type A Aortic Dissection?
Circulation, September 24, 2002; 106(12_suppl_1): I-218 - I-228.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
S. Kaji, T. Akasaka, Y. Horibata, K. Nishigami, H. Shono, M. Katayama, A. Yamamuro, S. Morioka, I. Morita, K. Tanemoto, et al.
Long-Term Prognosis of Patients With Type A Aortic Intramural Hematoma
Circulation, September 24, 2002; 106(12_suppl_1): I-248 - I-252.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
T. Caus, J. M. Frapier, R. Giorgi, T. Aymard, A. Riberi, B. Albat, P. A. Chaptal, and T. Mesana
Clinical outcome after repair of acute type A dissection in patients over 70 years-old
Eur. J. Cardiothorac. Surg., August 1, 2002; 22(2): 211 - 217.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
K. Kallenbach, K. Pethig, R.G. Leyh, D. Baric, A. Haverich, and W. Harringer
Acute dissection of the ascending aorta: first results of emergency valve sparing aortic root reconstruction
Eur. J. Cardiothorac. Surg., August 1, 2002; 22(2): 218 - 222.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
T. Kazui, N. Washiyama, A. H. M. Bashar, H. Terada, T. Suzuki, K. Ohkura, and K. Yamashita
Surgical outcome of acute type A aortic dissection: analysis of risk factors
Ann. Thorac. Surg., July 1, 2002; 74(1): 75 - 81.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
I. A. Khan and C. K. Nair
Clinical, Diagnostic, and Management Perspectives of Aortic Dissection*
Chest, July 1, 2002; 122(1): 311 - 328.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
S. Westaby, S. Saito, and T. Katsumata
Acute type A dissection: conservative methods provide consistently low mortality
Ann. Thorac. Surg., March 1, 2002; 73(3): 707 - 713.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
Y. Takahara, Y. Sudo, K. Mogi, M. Nakayama, and M. Sakurai
Total aortic arch grafting for acute type A dissection: analysis of residual false lumen
Ann. Thorac. Surg., February 1, 2002; 73(2): 450 - 454.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
M. Kirsch, C. Soustelle, R. Houel, M. L. Hillion, and D. Loisance
Risk factor analysis for proximal and distal reoperations after surgery for acute type A aortic dissection
J. Thorac. Cardiovasc. Surg., February 1, 2002; 123(2): 318 - 325.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
R. H. Mehta, T. Suzuki, P. G. Hagan, E. Bossone, D. Gilon, A. Llovet, L. C. Maroto, J. V. Cooper, D. E. Smith, W. F. Armstrong, et al.
Predicting Death in Patients With Acute Type A Aortic Dissection
Circulation, January 15, 2002; 105(2): 200 - 206.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
F. F. Immer, E. Krahenbuhl, A. S. Immer-Bansi, P. A. Berdat, B. Kipfer, F. S. Eckstein, H. Saner, and T. P. Carrel
Quality of life after interventions on the thoracic aorta with deep hypothermic circulatory arrest
Eur. J. Cardiothorac. Surg., January 1, 2002; 21(1): 10 - 14.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
K. Kawahito, H. Adachi, A. Yamaguchi, and T. Ino
Preoperative risk factors for hospital mortality in acute type A aortic dissection
Ann. Thorac. Surg., April 1, 2001; 71(4): 1239 - 1243.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
K. Kawahito, H. Adachi, A. Yamaguchi, and T. Ino
Early and late surgical outcomes of acute type a aortic dissection in patients aged 75 years and older
Ann. Thorac. Surg., November 1, 2000; 70(5): 1455 - 1459.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
T. P. Graeter, F. Langer, N. Nikoloudakis, D. Aicher, and H.-J. Schafers
Valve-preserving operation in acute aortic dissection type A
Ann. Thorac. Surg., November 1, 2000; 70(5): 1460 - 1465.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
T. G. Mesana, T. Caus, J.-Y. Gaubert, F. Collart, R. Ayari, J.-M. Bartoli, G. Moulin, and J.-R. Monties
Late complications after prosthetic replacement of the ascending aorta: what did we learn from routine magnetic resonance imaging follow-up?
Eur. J. Cardiothorac. Surg., September 1, 2000; 18(3): 313 - 320.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 1998 by The Society of Thoracic Surgeons.