University of Oulu

Jormalainen, M.; Raivio, P.; Biancari, F.; Mustonen, C.; Honkanen, H.-P.; Venermo, M.; Vento, A.; Juvonen, T. Late Outcome after Surgery for Type-A Aortic Dissection. J. Clin. Med. 2020, 9, 2731.

Late outcome after surgery for type-A aortic dissection

Saved in:
Author: Jormalainen, Mikko1; Raivio, Peter1; Biancari, Fausto1,2,3;
Organizations: 1Heart and Lung Center, Helsinki University Hospital, 00029 Helsinki, Finland
2Research Unit of Surgery, Anesthesia and Critical Care, University of Oulu, 90014 Oulu, Finland
3Department of Surgery, University of Turku, 20014 Turku, Finland
4Department of Vascular Surgery, Helsinki University Hospital, 00029 Helsinki, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.4 MB)
Persistent link:
Language: English
Published: Multidisciplinary Digital Publishing Institute, 2020
Publish Date: 2021-02-03


The aim of this study was to evaluate all-cause mortality and aortic reoperations after surgery for Stanford type A aortic dissection (TAAD). We evaluated the late outcome of patients who underwent surgery for acute TAAD from January 2005 to December 2017 at the Helsinki University Hospital, Finland. We studied 309 patients (DeBakey type I TAAD: 89.3%) who underwent repair of TAAD. Aortic root repair was performed in 94 patients (30.4%), hemiarch repair in 264 patients (85.4%) and partial/total aortic arch repair in 32 patients (10.4%). Hospital mortality was 13.6%. At 10 years, all-cause mortality was 34.9%, and the cumulative incidence of aortic reoperation or late aortic-related death was 15.6%, of any aortic reoperation 14.6%, reoperation on the aortic root 6.6%, on the aortic arch, descending thoracic and/or abdominal aorta 8.7%, on the descending thoracic and/or abdominal aorta 6.4%, and on the abdominal aorta 3.8%. At 10 years, cumulative incidence of reoperation on the distal aorta was higher in patients with a diameter of the descending thoracic aorta ≥35 mm at primary surgery (cumulative incidence in the overall series: 13.2% vs. 4.0%, SHR 3.993, 95%CI 1.316–12.120; DeBakey type I aortic dissection: 13.6% vs. 4.5%, SHR 3.610, 95%CI 1.193–10.913; patients with dissected descending thoracic aorta: 15.8% vs. 5.9%, SHR 3.211, 95%CI 1.067–9.664). In conclusion, surgical repair of TAAD limited to the aortic segments involved by the intimal tear was associated with favorable survival and a low rate of aortic reoperations. However, patients with enlarged descending thoracic aorta at primary surgery had higher risk of late reoperation. Half of the distal aortic reinterventions were performed on the abdominal aorta.

see all

Series: Journal of clinical medicine
ISSN: 2077-0383
ISSN-E: 2077-0383
ISSN-L: 2077-0383
Volume: 9
Issue: 9
Article number: 2731
DOI: 10.3390/jcm9092731
Type of Publication: A1 Journal article – refereed
Field of Science: 3126 Surgery, anesthesiology, intensive care, radiology
Copyright information: © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (