Surgical outcomes in acute type A aortic dissection based on surgeon experience

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Aortic Disease Management

Background:

• Acute aortic dissection Stanford A is a life-threatening condition requiring prompt surgical intervention.
• The safety and efficacy of surgical strategies can be influenced by surgeon experience.
• Evaluating outcomes based on surgeon experience is crucial for standardizing care.

Purpose of the Study:

• To assess the safety and appropriateness of a defined surgical strategy for acute aortic dissection Stanford A.
• To determine if the surgical strategy's effectiveness is independent of the primary surgeon's experience level.
• To compare outcomes between trainee and experienced surgeons performing the procedure.

Main Methods:

• Retrospective review of 160 patients undergoing open surgery for type A aortic dissection (April 2015–September 2020).
• Patients were divided into two groups: trainee surgeons (Group T) and experienced surgeons (Group E).
• Key outcomes evaluated included 30-day and in-hospital mortality, stroke, aortic reintervention, and mid-term survival.

Main Results:

• 30-day mortality rates were 5.1% (Group T) and 4.7% (Group E); in-hospital mortality rates were 7.7% (Group T) and 4.7% (Group E).
• One and 3-year survival rates were comparable: 88.4%/87.1% (Group T) vs. 95.3%/95.3% (Group E).
• Rates of permanent neurological dysfunction were similar (8.5% in Group T vs. 7.0% in Group E), with no significant difference in reintervention rates.

Conclusions:

• The implemented surgical strategy for acute type A aortic dissection is safe and effective.
• The strategy's success is not significantly dependent on the experience level of the primary surgeon.
• This approach offers a reliable option for managing acute aortic dissection Stanford A across different surgeon expertise levels.