Hemiarch Replacement in Acute type A Aortic dissection in patients with Arch branch vessel dissection is a risk factor for later re-intervention of the distal aorta
Presented During:
Saturday, May 6, 2023: 8:15AM - 8:30AM
Los Angeles Convention Center
Posted Room Name:
515B
Abstract No:
1
Submission Type:
Abstract Submission
Authors:
MAKOTO MATSUURA (1), Satoshi Kuroyanagi (2), Onichi Furuya (2)
Institutions:
(1) Kishiwada Tokusyukai hospital, Kishiwada, Osaka, (2) Kishiwada Tokushukai hospital, Kishiwada, Osaka
Submitting Author:
MAKOTO MATSUURA
-
Contact Me
Kishiwada Tokusyukai hospital
Kishiwada Tokusyukai hospital
Co-Author(s):
Satoshi Kuroyanagi
-
Contact Me
Kishiwada Tokushukai hospital
Kishiwada Tokushukai hospital
Onichi Furuya
-
Contact Me
Kishiwada Tokushukai hospital
Kishiwada Tokushukai hospital
Presenting Author:
MAKOTO MATSUURA
-
Contact Me
Kishiwada Tokusyukai hospital
Kishiwada Tokusyukai hospital
Abstract:
Objective:
The study was performed to identify the long-term outcome after hemiarch replacement for patients with acute type A aortic dissection and arch branch dissection.
Method:
From January 2008 to December 2021, 466 patients underwent open acute type A aortic dissection surgery. After excluding those who underwent total arch replacement(n=56), 411 patients met the criteria. Patients were divided into those with arch branch vessel dissection(n=204) and those without arch vessel dissection(n=207).
Result:
The median age of the entire cohort was 72 years, and other preoperative comorbidities were similar between the two groups. Both groups received aortic root replacement similarly (10% vs. 9%, P=0.60), and other intraoperative outcomes are similar. However, Deep hypothermic circulatory arrest time is a little longer in those without arch branch vessel dissection (41min vs. 45min, P=0.007). Postoperative outcomes were similar between the two groups, including operative mortality (9% vs. 7% P=0.478) and stroke (8% vs. 12% P=0.11). An anastomosis-related new entry was seen more in the arch branch dissection group (53% vs. 12% P<0.001). The arch branch vessel dissection group had a significantly greater cumulative incidence of reoperation for distal aorta (5-year 30% vs. 12% P<0.001) with a hazard ratio of 9.75(95% confidence interval, 6.92-14.6 P<0.001). The 10-year survival was similar between the arch-branch vessel dissection and no arch-branch vessel dissection groups (50% vs. 55% P=0.39).
An anastomosis-related new entry was associated with re-operation for the distal aorta (hazard ratio 3.17, P<0.001).
Conclusions:
Hemiarch replacement for patients with acute aortic dissection with arch branch vessel dissection was associated with the anastomosis-related new entry and later re-intervention of the distal aorta
The study was performed to identify the long-term outcome after hemiarch replacement for patients with acute type A aortic dissection and arch branch dissection.
Method:
From January 2008 to December 2021, 466 patients underwent open acute type A aortic dissection surgery. After excluding those who underwent total arch replacement(n=56), 411 patients met the criteria. Patients were divided into those with arch branch vessel dissection(n=204) and those without arch vessel dissection(n=207).
Result:
The median age of the entire cohort was 72 years, and other preoperative comorbidities were similar between the two groups. Both groups received aortic root replacement similarly (10% vs. 9%, P=0.60), and other intraoperative outcomes are similar. However, Deep hypothermic circulatory arrest time is a little longer in those without arch branch vessel dissection (41min vs. 45min, P=0.007). Postoperative outcomes were similar between the two groups, including operative mortality (9% vs. 7% P=0.478) and stroke (8% vs. 12% P=0.11). An anastomosis-related new entry was seen more in the arch branch dissection group (53% vs. 12% P<0.001). The arch branch vessel dissection group had a significantly greater cumulative incidence of reoperation for distal aorta (5-year 30% vs. 12% P<0.001) with a hazard ratio of 9.75(95% confidence interval, 6.92-14.6 P<0.001). The 10-year survival was similar between the arch-branch vessel dissection and no arch-branch vessel dissection groups (50% vs. 55% P=0.39).
An anastomosis-related new entry was associated with re-operation for the distal aorta (hazard ratio 3.17, P<0.001).
Conclusions:
Hemiarch replacement for patients with acute aortic dissection with arch branch vessel dissection was associated with the anastomosis-related new entry and later re-intervention of the distal aorta
ADULT CARDIAC:
Aorta and Great Vessels
Image or Table
