[Influence of an Operative Strategy on Outcomes of Acute Type A Aortic Dissection Cases]

To compare the surgical outcomes of total arch replacement with the outcomes of ascending aorta replacement in patients with acute Stanford type A aortic dissection.

From April 2002 to May 2014, 90 patients with acute Stanford type A aortic dissection underwent emergency surgical treatment at our institution. Among them, 16 underwent total arch replacement and 74 underwent ascending aorta replacement. The decision to perform total arch versus ascending aorta replacement was dependent on an intimal tearing site.

There were no statistically significant differences in characteristics between the groups with regard to the 2 surgical procedures. Twenty early deaths were reported, but there was no statistically significant difference in mortality rate between the groups. The aortic operation had to be redone in 12 patients. The reoperations were not associated with an increased risk of death or neurological complications. Overall 5-year survival rates were 68% in the ascending aorta replacement group and 59% in the total arch replacement group. There was no statistically significant difference between the groups.

The surgical outcome and prognosis of ascending aorta replacement is satisfactory among patients undergoing treatment of acute type A aortic dissection.