[Surgical treatment of type A acute aortic syndrome: a single-center 10-year experience]

Acute Aortic Syndrome (AAS) affecting the ascending aorta still represents a challenge to cardiologists and cardiothoracic surgeons, being associated with high mortality even with early surgery.

To describe the immediate post-operative results and long-term survival after the surgical treatment of type A AAS. Secondary outcomes include hospital mortality, length of hospital stay and long-term mortality.

Retrospective longitudinal study, including all patients who underwent ascending aorta replacement for surgical treatment of type A AAS, in a tertiary center, between January 2005 and December 2015. Preoperative, surgical and postoperative characteristics were evaluated. In addition to the descriptive analysis, the impact of some variables on long-term mortality, hospital mortality and length of hospital stay was evaluated.

We included 78 patients, the most common type of AAS was aortic dissection (92,3%). 6 patients died at operation room and 12 in the immediate post-operative period, completing 23,1% of in-hospital mortality. Considering 60 survivors who were followed by a mean time of 5 years, maximum of 12, we registered a cumulative survival at 1, 3, 5, 10-years of 93,5%, 84,3%, 77% and 69,5%, respectively. Marfan Syndrome was found to be a risk factor of higher long term mortality (HR: 3,85, p=0,045).

Our study confirms previous observations associating AAS type A with high rates of morbidity and mortality, despite significant advances in diagnostic and therapeutic techniques.