Related Experiment Video
Updated: Feb 13, 2026
Novel and Innovative Hybrid Technique for Type A Aortic Dissection
Published on: March 28, 2025
Acute type A aortic dissection repair in younger patients
Kyokun Uehara1, Hitoshi Matsuda1, Jiro Matsuo1
1Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
Insights
Surgical repair of acute type A aortic dissection in young patients yields satisfactory outcomes. A persistent false lumen increases reoperation risk but not long-term mortality, necessitating close follow-up.
Area of Science:
- Cardiovascular Surgery
- Aortic Dissection Research
- Thoracic Aortic Disease
Background:
- Acute type A aortic dissection (AAAD) presents unique challenges in younger patient populations.
- Understanding long-term outcomes is crucial for optimizing treatment strategies in patients under 50.
Purpose of the Study:
- To evaluate the surgical outcomes and midterm results of patients under 50 years old who underwent repair for acute type A aortic dissection (AAAD).
Main Methods:
- Retrospective analysis of 51 patients under 50 who underwent AAAD repair between 2003 and 2016.
- Surgical procedures included total arch replacement (76.5%) or hemiarch replacement (23.5%), with 39.2% undergoing concomitant surgeries.
- Data collected on demographics, comorbidities, surgical details, and long-term follow-up outcomes.
Main Results:
- Low in-hospital mortality (2.0%) with 5-year and 10-year overall survival rates of 87.7% and 81.9%, respectively.
- Reoperation rates were 60.2% at 5 years and 50.2% at 10 years, with a patent false lumen being a significant risk factor (P < 0.001).
- Causes for reoperation included aortic dilatation, root dissection, infection, and hemolysis.
Conclusions:
- Surgical repair of AAAD in young patients demonstrates satisfactory midterm results.
- A patent false lumen is a significant predictor of reoperation but does not impact long-term survival.
- Mandatory close follow-up is essential for young patients post-AAAD repair to monitor for complications.
Aim:
To evaluate the surgical outcomes and midterm results of patients under 50 years old with acute type A aortic dissection (AAAD).
Methods:
The study population included 51 patients who underwent AAAD repair between 2003 and 2016. Of these 51 patients, 46 (90.1%) were males and 14 (27.5%) had connective tissue disorders. Twenty-five patients (49.0%) had a body mass index >25.0 kg/m2 and two patients were pregnant. Total arch replacement was performed in 39 patients (76.5%) and hemiarch replacement in 12 patients (23.5%). Twenty patients (39.2%) underwent concomitant surgeries, including root replacement, lower limb bypass, or coronary artery bypass grafting.
Results:
There was one in-hospital death (2.0%). Median follow-up was 55 months and overall survival rates were 87.7% at 5 years and 81.9% at 10 years. Rates of freedom from reoperation were 60.2% at 5 years and 50.2% at 10 years. Eighteen patients (35.3%) required reoperation, due to progressive aortic dilatation, new dissection in the aortic root, infection, and hemolysis. A patent false lumen represented a significant risk factor for reoperation (P < 0.001). Four patients (7.8%) underwent reoperation within 3 months after the initial repair.
Conclusions:
Surgical outcomes after AAAD repair for young patients were satisfactory. A patent false lumen significantly increased the need for reoperation (P = 0.002), but did not affect long-term survival. Close follow-up is mandatory after the initial repair in young patients following AAAD.
Related Concept Videos
02:25Overview of DNA Repair
Chemically...
01:36Mismatch Repair
01:20Mismatch Repair
The Mutator Protein Family Plays a Key Role in DNA Mismatch Repair
The human genome has more than 3 billion base pairs of DNA per cell. Prior to cell division, that vast amount of genetic...
01:08Nucleotide Excision Repair
01:38Nucleotide Excision Repair
Cells are regularly exposed to mutagens—factors in the environment that can damage DNA and generate mutations. UV radiation is one of the most common mutagens and is estimated to introduce a significant number of changes in DNA. These include bends or kinks in the structure, which can block DNA replication or transcription. If these errors are not fixed, the damage can cause mutations, which in turn can result in cancer or disease depending on which sequences are...
01:54Base Excision Repair
The first step of...