Long-term outcome following repair of acute type A aortic dissection after previous cardiac surgery
Abstract We evaluated the outcome after repair for acute spontaneous type A aortic dissection in patients with previous cardiac surgery. From January 2000 to December 2009, 114 patients underwent emergency repair for acute spontaneous type A dissection at Southampton University Hospital. Eleven (med...
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| Veröffentlicht in: | Interactive cardiovascular and thoracic surgery 2011-10, Vol.13 (4), p.386-391 |
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| creator | Modi, Amit Vohra, Hunaid A. Kaarne, Markku Haw, Marcus P. Barlow, Clifford W. Ohri, Sunil K. Livesey, Steven A. Tsang, Geoffrey M.K. |
| description | Abstract
We evaluated the outcome after repair for acute spontaneous type A aortic dissection in patients with previous cardiac surgery. From January 2000 to December 2009, 114 patients underwent emergency repair for acute spontaneous type A dissection at Southampton University Hospital. Eleven (median age 64 years; range 36-83 years; two females) patients (9.8%) had undergone previous cardiac surgery and were included in this study. Aortic root replacement was performed in three patients (27%), aortic arch replacement in four patients (36%) and two patients (18%) required aortic valve re-suspension. The elephant trunk operation was performed in two patients (18%). There were two hospital deaths (18%). Two patients (18%) suffered a stroke, two needed re-opening for bleeding (18%) and two patients (18%) required haemofiltration postoperatively. Median length of hospital stay was 16 days (range 6-34 days). Actuarial survival at five and eight years for redo compared to first-time surgery was 68±3.63% vs. 81±5.34% and 51±3.8% vs. 61±5.4%, respectively (P=0.365). In conclusion, acute type A aortic dissection repair in patients with previous cardiac surgery has an acceptable mortality and comparable long-term outcome to first-time surgery. |
| doi_str_mv | 10.1510/icvts.2011.266692 |
| format | Article |
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We evaluated the outcome after repair for acute spontaneous type A aortic dissection in patients with previous cardiac surgery. From January 2000 to December 2009, 114 patients underwent emergency repair for acute spontaneous type A dissection at Southampton University Hospital. Eleven (median age 64 years; range 36-83 years; two females) patients (9.8%) had undergone previous cardiac surgery and were included in this study. Aortic root replacement was performed in three patients (27%), aortic arch replacement in four patients (36%) and two patients (18%) required aortic valve re-suspension. The elephant trunk operation was performed in two patients (18%). There were two hospital deaths (18%). Two patients (18%) suffered a stroke, two needed re-opening for bleeding (18%) and two patients (18%) required haemofiltration postoperatively. Median length of hospital stay was 16 days (range 6-34 days). Actuarial survival at five and eight years for redo compared to first-time surgery was 68±3.63% vs. 81±5.34% and 51±3.8% vs. 61±5.4%, respectively (P=0.365). In conclusion, acute type A aortic dissection repair in patients with previous cardiac surgery has an acceptable mortality and comparable long-term outcome to first-time surgery.</description><identifier>ISSN: 1569-9293</identifier><identifier>EISSN: 1569-9285</identifier><identifier>DOI: 10.1510/icvts.2011.266692</identifier><identifier>PMID: 21729948</identifier><language>eng</language><publisher>England: European Association for Cardio-Thoracic Surgery</publisher><subject>Acute Disease ; Acute Kidney Injury - etiology ; Acute Kidney Injury - therapy ; Adult ; Aged ; Aged, 80 and over ; Aneurysm, Dissecting - mortality ; Aneurysm, Dissecting - surgery ; Aortic Aneurysm - mortality ; Aortic Aneurysm - surgery ; Blood Vessel Prosthesis Implantation - adverse effects ; Blood Vessel Prosthesis Implantation - mortality ; Cardiac Surgical Procedures ; Chi-Square Distribution ; England ; Female ; Hemofiltration ; Hospital Mortality ; Hospitals, University ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Patient Selection ; Postoperative Hemorrhage - etiology ; Postoperative Hemorrhage - surgery ; Reoperation ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Stroke - etiology ; Time Factors ; Treatment Outcome</subject><ispartof>Interactive cardiovascular and thoracic surgery, 2011-10, Vol.13 (4), p.386-391</ispartof><rights>20011 Published by European Association for Cardio-Thoracic Surgery. All rights reserved. 2011</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c337t-def1a3ffbe48e71cf355488c66d8cb2d0765bf56fa671842ad445263bd5d00e3</citedby><cites>FETCH-LOGICAL-c337t-def1a3ffbe48e71cf355488c66d8cb2d0765bf56fa671842ad445263bd5d00e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21729948$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Modi, Amit</creatorcontrib><creatorcontrib>Vohra, Hunaid A.</creatorcontrib><creatorcontrib>Kaarne, Markku</creatorcontrib><creatorcontrib>Haw, Marcus P.</creatorcontrib><creatorcontrib>Barlow, Clifford W.</creatorcontrib><creatorcontrib>Ohri, Sunil K.</creatorcontrib><creatorcontrib>Livesey, Steven A.</creatorcontrib><creatorcontrib>Tsang, Geoffrey M.K.</creatorcontrib><title>Long-term outcome following repair of acute type A aortic dissection after previous cardiac surgery</title><title>Interactive cardiovascular and thoracic surgery</title><addtitle>Interact CardioVasc Thorac Surg</addtitle><addtitle>Interact Cardiovasc Thorac Surg</addtitle><description>Abstract
We evaluated the outcome after repair for acute spontaneous type A aortic dissection in patients with previous cardiac surgery. From January 2000 to December 2009, 114 patients underwent emergency repair for acute spontaneous type A dissection at Southampton University Hospital. Eleven (median age 64 years; range 36-83 years; two females) patients (9.8%) had undergone previous cardiac surgery and were included in this study. Aortic root replacement was performed in three patients (27%), aortic arch replacement in four patients (36%) and two patients (18%) required aortic valve re-suspension. The elephant trunk operation was performed in two patients (18%). There were two hospital deaths (18%). Two patients (18%) suffered a stroke, two needed re-opening for bleeding (18%) and two patients (18%) required haemofiltration postoperatively. Median length of hospital stay was 16 days (range 6-34 days). Actuarial survival at five and eight years for redo compared to first-time surgery was 68±3.63% vs. 81±5.34% and 51±3.8% vs. 61±5.4%, respectively (P=0.365). In conclusion, acute type A aortic dissection repair in patients with previous cardiac surgery has an acceptable mortality and comparable long-term outcome to first-time surgery.</description><subject>Acute Disease</subject><subject>Acute Kidney Injury - etiology</subject><subject>Acute Kidney Injury - therapy</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aneurysm, Dissecting - mortality</subject><subject>Aneurysm, Dissecting - surgery</subject><subject>Aortic Aneurysm - mortality</subject><subject>Aortic Aneurysm - surgery</subject><subject>Blood Vessel Prosthesis Implantation - adverse effects</subject><subject>Blood Vessel Prosthesis Implantation - mortality</subject><subject>Cardiac Surgical Procedures</subject><subject>Chi-Square Distribution</subject><subject>England</subject><subject>Female</subject><subject>Hemofiltration</subject><subject>Hospital Mortality</subject><subject>Hospitals, University</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Patient Selection</subject><subject>Postoperative Hemorrhage - etiology</subject><subject>Postoperative Hemorrhage - surgery</subject><subject>Reoperation</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Stroke - etiology</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>1569-9293</issn><issn>1569-9285</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkLtOwzAUQC0E4lH4ABbkjYUUP2InHquKl1SJhT1y7OvKKKmD7RT17wm0MDPdO5x7dHUQuqZkTgUl995sc5ozQumcSSkVO0LnVEhVKFaL479d8TN0kdI7IVQRTk7RGaMVU6qsz5FZhc26yBB7HMZsQg_Yha4Ln36zxhEG7SMODmszZsB5NwBeYB1i9gZbnxKY7MMGazcZ8BBh68OYsNHRem1wGuMa4u4SnTjdJbg6zBl6e3x4Wz4Xq9enl-ViVRjOq1xYcFRz51ooa6iocVyIsq6NlLY2LbOkkqJ1QjotK1qXTNuyFEzy1gpLCPAZut1rhxg-Rki56X0y0HV6A9NXTa14RRUTaiLpnjQxpBTBNUP0vY67hpLmu2zzU7b5Ltvsy043Nwf72PZg_y5-U07A3R4I4_AP3xckw4V_</recordid><startdate>20111001</startdate><enddate>20111001</enddate><creator>Modi, Amit</creator><creator>Vohra, Hunaid A.</creator><creator>Kaarne, Markku</creator><creator>Haw, Marcus P.</creator><creator>Barlow, Clifford W.</creator><creator>Ohri, Sunil K.</creator><creator>Livesey, Steven A.</creator><creator>Tsang, Geoffrey M.K.</creator><general>European Association for Cardio-Thoracic Surgery</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20111001</creationdate><title>Long-term outcome following repair of acute type A aortic dissection after previous cardiac surgery</title><author>Modi, Amit ; Vohra, Hunaid A. ; Kaarne, Markku ; Haw, Marcus P. ; Barlow, Clifford W. ; Ohri, Sunil K. ; Livesey, Steven A. ; Tsang, Geoffrey M.K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c337t-def1a3ffbe48e71cf355488c66d8cb2d0765bf56fa671842ad445263bd5d00e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Acute Disease</topic><topic>Acute Kidney Injury - etiology</topic><topic>Acute Kidney Injury - therapy</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aneurysm, Dissecting - mortality</topic><topic>Aneurysm, Dissecting - surgery</topic><topic>Aortic Aneurysm - mortality</topic><topic>Aortic Aneurysm - surgery</topic><topic>Blood Vessel Prosthesis Implantation - adverse effects</topic><topic>Blood Vessel Prosthesis Implantation - mortality</topic><topic>Cardiac Surgical Procedures</topic><topic>Chi-Square Distribution</topic><topic>England</topic><topic>Female</topic><topic>Hemofiltration</topic><topic>Hospital Mortality</topic><topic>Hospitals, University</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Patient Selection</topic><topic>Postoperative Hemorrhage - etiology</topic><topic>Postoperative Hemorrhage - surgery</topic><topic>Reoperation</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Stroke - etiology</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Modi, Amit</creatorcontrib><creatorcontrib>Vohra, Hunaid A.</creatorcontrib><creatorcontrib>Kaarne, Markku</creatorcontrib><creatorcontrib>Haw, Marcus P.</creatorcontrib><creatorcontrib>Barlow, Clifford W.</creatorcontrib><creatorcontrib>Ohri, Sunil K.</creatorcontrib><creatorcontrib>Livesey, Steven A.</creatorcontrib><creatorcontrib>Tsang, Geoffrey M.K.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Interactive cardiovascular and thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Modi, Amit</au><au>Vohra, Hunaid A.</au><au>Kaarne, Markku</au><au>Haw, Marcus P.</au><au>Barlow, Clifford W.</au><au>Ohri, Sunil K.</au><au>Livesey, Steven A.</au><au>Tsang, Geoffrey M.K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-term outcome following repair of acute type A aortic dissection after previous cardiac surgery</atitle><jtitle>Interactive cardiovascular and thoracic surgery</jtitle><stitle>Interact CardioVasc Thorac Surg</stitle><addtitle>Interact Cardiovasc Thorac Surg</addtitle><date>2011-10-01</date><risdate>2011</risdate><volume>13</volume><issue>4</issue><spage>386</spage><epage>391</epage><pages>386-391</pages><issn>1569-9293</issn><eissn>1569-9285</eissn><abstract>Abstract
We evaluated the outcome after repair for acute spontaneous type A aortic dissection in patients with previous cardiac surgery. From January 2000 to December 2009, 114 patients underwent emergency repair for acute spontaneous type A dissection at Southampton University Hospital. Eleven (median age 64 years; range 36-83 years; two females) patients (9.8%) had undergone previous cardiac surgery and were included in this study. Aortic root replacement was performed in three patients (27%), aortic arch replacement in four patients (36%) and two patients (18%) required aortic valve re-suspension. The elephant trunk operation was performed in two patients (18%). There were two hospital deaths (18%). Two patients (18%) suffered a stroke, two needed re-opening for bleeding (18%) and two patients (18%) required haemofiltration postoperatively. Median length of hospital stay was 16 days (range 6-34 days). Actuarial survival at five and eight years for redo compared to first-time surgery was 68±3.63% vs. 81±5.34% and 51±3.8% vs. 61±5.4%, respectively (P=0.365). In conclusion, acute type A aortic dissection repair in patients with previous cardiac surgery has an acceptable mortality and comparable long-term outcome to first-time surgery.</abstract><cop>England</cop><pub>European Association for Cardio-Thoracic Surgery</pub><pmid>21729948</pmid><doi>10.1510/icvts.2011.266692</doi><tpages>6</tpages></addata></record> |
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| subjects | Acute Disease Acute Kidney Injury - etiology Acute Kidney Injury - therapy Adult Aged Aged, 80 and over Aneurysm, Dissecting - mortality Aneurysm, Dissecting - surgery Aortic Aneurysm - mortality Aortic Aneurysm - surgery Blood Vessel Prosthesis Implantation - adverse effects Blood Vessel Prosthesis Implantation - mortality Cardiac Surgical Procedures Chi-Square Distribution England Female Hemofiltration Hospital Mortality Hospitals, University Humans Kaplan-Meier Estimate Male Middle Aged Patient Selection Postoperative Hemorrhage - etiology Postoperative Hemorrhage - surgery Reoperation Retrospective Studies Risk Assessment Risk Factors Stroke - etiology Time Factors Treatment Outcome |
| title | Long-term outcome following repair of acute type A aortic dissection after previous cardiac surgery |
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