A comprehensive multidisciplinary thoracic aortic program improves patient quality metrics after type A aortic...

Area of Science:

• Cardiovascular Surgery
• Thoracic Aortic Disease Management
• Quality Improvement in Healthcare

Background:

• Type A aortic dissection is a life-threatening condition requiring specialized, coordinated care.
• Establishing a multidisciplinary thoracic aortic program (MTAP) aims to optimize management and outcomes for these complex patients.
• Evaluating the impact of such programs on quality metrics is crucial for advancing patient care.

Purpose of the Study:

• To assess the effect of a multidisciplinary thoracic aortic program (MTAP) on quality care metrics in survivors of type A aortic dissection.
• To compare process-of-care metrics before and after the implementation of an MTAP.

Main Methods:

• A single academic institution compared quality-care metrics for type A aortic dissection repair patients.
• Data from 5 years pre-MTAP (2014-2018, n=87) were compared to 4 years post-MTAP (2019-2022, n=126).
• Key metrics included follow-up, aortic imaging surveillance, genetic testing, and reintervention strategies.

Main Results:

• The MTAP cohort showed higher rates of genetic testing (34% vs 15%) and aortic surveillance imaging (1.3 vs 0.49 scans/year).
• Vascular surgeon follow-up increased (62% vs 46%), and fewer patients were lost to follow-up (25% vs 38%).
• Reinterventions were more frequently planned (33% vs 11%) and endovascularly performed (91% vs 54%) in the MTAP group, with no emergent reinterventions.

Conclusions:

• Implementation of an MTAP significantly improved clinical follow-up and diagnostic testing for type A aortic dissection survivors.
• The MTAP facilitated a shift towards planned, endovascular reinterventions, enhancing patient management.
• Establishing specialized multidisciplinary programs is vital for optimizing care pathways in thoracic aortic disease.