Improved Survival After Implementation of a Large-Scale Regional Dedicated Aortic Network

• Published in: Journal of the American College of Cardiology Vol. 70; no. 24; pp. 3068 - 3069
• Main Authors: Duceau, Baptiste, Alsac, Jean-Marc, Bellenfant, Florence, Mailloux, Arnaud, Chhor, Vibol, Lagrange, Alix, El Batti, Salma, Cholley, Bernard, Achouh, Paul, Pirracchio, Romain
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 19-12-2017; Elsevier Limited
• Subjects: Aneurysm, Dissecting - mortality; Aneurysm, Dissecting - surgery; Aneurysms; Aortic Aneurysm, Thoracic - mortality; Aortic Aneurysm, Thoracic - surgery; Aortic dissection; Blood Vessel Prosthesis Implantation - methods; Cardiology; Confidence intervals; Coronary vessels; Diagnosis; Dissection; Global Health; Heart surgery; Hospital Mortality - trends; Hospitals; Humans; Medical diagnosis; Mortality; Multivariate analysis; Prostheses; Survival; Survival Rate - trends; Thrombosis; France
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/j.jacc.2017.10.026

The final diagnosis was an AAD in 579 (69.5%) cases distributed nonexclusively as follows: 370 (44.4%) acute aortic syndrome (type A aortic dissection, n = 217 [26.1%]; type B aortic dissection, n = 115 [13.8%]; intramural hematoma, n = 24 [2.9%]; penetrating aortic ulcer, n = 7 [0.8%]; or traumatic aortic injury, n = 7 [0.8%]), 77 (9.2%) nonruptured and 127 (15.2%) ruptured aortic aneurysm, 9 (1.1%) aortic prosthesis complication, and 8 (1%) aortic thrombosis. In multivariate analysis, the second period (M58 to M77) was associated with a significantly decreased risk of 30-day hospital mortality (hazard ratio: 0.62; 95% confidence interval: 0.43 to 0.89; p = 0.011). 1 J. Chikwe, P. Cavallaro, S. Itagaki, M. Seigerman, G. DiLuozzo, D.H. Adams, National outcomes in acute aortic dissection: influence of surgeon and institutional volume on operative mortality, Ann Thorac Surg, Vol. 95, 2013, 1563-1569 2 N.D. Andersen, A.M. Ganapathi, J.M. Hanna, J.B. Williams, J.G. Gaca, G.C. Hughes, Outcomes of acute type a dissection repair before and after implementation of a multidisciplinary thoracic aortic surgery program, J Am Coll Cardiol, Vol. 63, 2014, 1796-1803 3 K.M. Harris, C.E. Strauss, K.A. Eagle, Correlates of delayed recognition and treatment of acute type A aortic dissection: the International Registry of Acute Aortic Dissection (IRAD), Circulation, Vol. 124, 2011, 1911-1918 4 2014 ESC Guidelines on the diagnosis and treatment of aortic diseases: