A Comparative Study of the Early and Short-Term Outcomes of Aortic Replacement in Patients with Stanford type A Aortic Dissection and Ascending Aortic Aneurysm.

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Erfan Omer Anwar Shkar Raouf Haji Saeed Aram Baram .

Abstract

Ascending aortic replacement is a challenging and complex surgery. The mortality, morbidity, and outcomes depend on the causes of the ascending aortic pathology and the type of operation. The research was conducted in a single-center, prospective, observational cohort study of patients undergoing ascending aortic replacement due to dissection or aneurysm. In the hospital, mortality, morbidity, and short-term outcomes were measured. A total of 85 patients were included in this study. Of them, 65.9% were male, and 34.1% were female. Thirty-three patients had Stanford type A aortic dissection (STAAD), whereas 52 had ascending aortic aneurysm (ASAA). Early mortality was (21.21% and 1.9%) for STAAD and ASAA, respectively, while the survival rate after one year was (75.8% and 96.15 %) for ascending dissection and aneurysm, respectively. The results of our study show higher early surgical mortality and morbidity and a lower short-term survival rate for STAAD surgery compared with ASAA surgery.

Keywords

Aorta, Ascending Aorta, Aortic Dissection, Ascending Aortic Aneurysm. Early Mortality and Morbidity.

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References

[1] P. Komutrattananont, P. Mahakkanukrauh, and S. Das, “Morphology of the human aorta
and age-related changes: anatomical facts,” Anatomy & Cell Biology, vol. 52, no. 2, pp. 109–
114, Jun. 2019, doi: 10.5115/acb.2019.52.2.109.
[2] H. J. White, S. Bordes, and J. Borger, “Anatomy, Abdomen and Pelvis, Aorta,” PubMed,
2020. https://www.ncbi.nlm.nih.gov/books/NBK537319/
[3] H. Murillo, M. J. Lane, R. Punn, D. Fleischmann, and C. S. Restrepo, “Imaging of the
Aorta: Embryology and Anatomy,” Seminars in Ultrasound, CT and MRI, vol. 33, no. 3, pp.
169–190, Jun. 2012, doi: 10.1053/j.sult.2012.01.013.
[4] D. Kamalakannan, H. S. Rosman, and K. A. Eagle, “Acute Aortic Dissection,” Critical
Care Clinics, vol. 23, no. 4, pp. 779–800, Oct. 2007, doi: 10.1016/j.ccc.2007.07.002.
[5] I. A. De León Ayala and Y.-F. Chen, “Acute aortic dissection: An update,” The
Kaohsiung Journal of Medical Sciences, vol. 28, no. 6, pp. 299–305, Jun. 2012, doi:
10.1016/j.kjms.2011.11.010.
[6] R. S. Elsayed, R. G. Cohen, F. Fleischman, and M. E. Bowdish, “Acute Type A Aortic
Dissection,” Cardiology Clinics, vol. 35, no. 3, pp. 331–345, Aug. 2017, doi:
10.1016/j.ccl.2017.03.004.
[7] S. Upadhye and K. Schiff, “Acute Aortic Dissection in the Emergency Department:
Diagnostic Challenges and Evidence-Based Management,” Emergency Medicine Clinics of
North America, vol. 30, no. 2, pp. 307–327, May 2012, doi: 10.1016/j.emc.2011.12.001.
[8] E. Saliba, Y. Sia, A. Dore, and I. El Hamamsy, “The ascending aortic aneurysm: When
to intervene?” IJC Heart & Vasculature, vol. 6, pp. 91–100, Mar. 2015, doi:
10.1016/j.ijcha.2015.01.009.
[9] J. K. Ehrman, A. B. Fernandez, J. Myers, P. Oh, P. D. Thompson, and S. J. Keteyian,
“Aortic Aneurysm,” Journal of Cardiopulmonary Rehabilitation and Prevention, vol. 40, no. 4,
pp. 215–223, Jul. 2020, doi: 10.1097/hcr.0000000000000521.
[10] M. J. Salameh, J. H. Black, and E. V. Ratchford, “Thoracic aortic aneurysm,” Vascular
Medicine, vol. 23, no. 6, pp. 573–578, Oct. 2018, doi: 10.1177/1358863x18807760.
[11] P. D. Patel and R. R. Arora, “Pathophysiology, diagnosis, and management of aortic
dissection,” Therapeutic Advances in Cardiovascular Disease, vol. 2, no. 6, pp. 439–468, Sep.
2008, doi: 10.1177/1753944708090830.
[12] E. L. Meredith and N. D. Masani, “Echocardiography in the emergency assessment of
acute aortic syndromes,” European Journal of Echocardiography, vol. 10, no. 1, pp. i31–i39,
Jan. 2009, doi: 10.1093/ejechocard/jen251.
[13] D. MUKHERJEE and K. EAGLE, “Aortic Dissection—An Update,” Current Problems
in Cardiology, vol. 30, no. 6, pp. 287–325, Jun. 2005, doi: 10.1016/j.cpcardiol.2005.01.002.
[14] C. R. Bonnichsen et al., “Aneurysms of the ascending aorta and arch: the role of imaging
in diagnosis and surgical management,” Expert Review of Cardiovascular Therapy, vol. 9, no.
1, pp. 45–61, Jan. 2011, doi: 10.1586/erc.10.168.
[15] S. Trimarchi et al., “Contemporary results of surgery in acute type A aortic dissection:
The International Registry of Acute Aortic Dissection experience,” The Journal of Thoracic
and Cardiovascular Surgery, vol. 129, no. 1, pp. 112–122, Jan. 2005, doi:
10.1016/j.jtcvs.2004.09.005.
[16]D. Hernandez-Vaquero et al., “Life Expectancy after Surgery for Ascending Aortic
Aneurysm,” Journal of Clinical Medicine, vol. 9, no. 3, p. 615, Feb. 2020, doi:
10.3390/jcm9030615.
[17] B. Chiappini, M. Schepens, and E. Tan, “Early and Late Outcomes of Acute Type A
Aortic Dissection: Analysis of Risk Factors in 487 Consecutive Patients,” ACC Current
Journal Review, vol. 14, no. 5, p. 45, May 2005, doi: 10.1016/j.accreview.2005.04.038.
[18] Z. S. Meharwal, S. N. Khanna, A. Choudhary, M. Mishra, Y. Mehta, and N. Trehan,
“Ascending Aortic Aneurysm Resection: 15 Years’ Experience,” Asian Cardiovascular and
Thoracic Annals, vol. 14, no. 4, pp. 300–305, Aug. 2006, doi: 10.1177/021849230601400407.
[19] “NIH Stroke Scale: National Institutes of Health (NIH) Stroke Scale,” eMedicine, Jun. 2022,
Accessed: Sep. 20, 2022. [Online]. Available: https://emedicine.medscape.com/article/2172609-
overview.
[20] J. A. Lopes and S. Jorge, “The RIFLE and AKIN classifications for acute kidney injury:
a critical and comprehensive review,” Clinical Kidney Journal, vol. 6, no. 1, pp. 8–14, Jan.
2013, doi: 10.1093/ckj/sfs160.
[21] R. S. McClure, S. B. Brogly, K. Lajkosz, D. Payne, S. F. Hall, and A. P. Johnson,
“Epidemiology and management of thoracic aortic dissections and thoracic aortic aneurysms
in Ontario, Canada: A population-based study,” The Journal of Thoracic and Cardiovascular
Surgery, vol. 155, no. 6, pp. 2254-2264.e4, Jun. 2018, doi: 10.1016/j.jtcvs.2017.11.105.
[22] T. Gudbjartsson et al., “Acute type A aortic dissection – a review,” Scandinavian
Cardiovascular Journal, vol. 54, no. 1, pp. 1–13, Sep. 2019, doi:
10.1080/14017431.2019.1660401.
[23] Y. Lu et al., “Management strategy of Type A Aortic Dissection in a developing center
from China: 16 years experiences,” Journal of Thoracic Disease, vol. 12, no. 11, pp. 6780–
6788, Nov. 2020, doi: 10.21037/jtd-20-1866.
[24] K. Kallenbach et al., “Treatment of ascending aortic aneurysms by different surgical
techniques: Comparison of early and long-term results,” The Thoracic and Cardiovascular
Surgeon, vol. 60, no. S 01, Jan. 2012, doi: 10.1055/s-0031-1297910.
[25] P. G. Hagan et al., “The International Registry of Acute Aortic Dissection (IRAD),”
JAMA, vol. 283, no. 7, p. 897, Feb. 2000, doi: 10.1001/jama.283.7.897.
[26] D. Pacini et al., “Acute aortic dissection: Epidemiology and outcomes,” International
Journal of Cardiology, vol. 167, no. 6, pp. 2806–2812, Sep. 2013, doi:
10.1016/j.ijcard.2012.07.008.