University of Oulu

Herajärvi, J., Jormalainen, M., Mustonen, C., Kesävuori, R., Raivio, P., Biancari, F., & Juvonen, T. (2022). 13-year single-center experience with the treatment of acute type B aortic dissection. Scandinavian Cardiovascular Journal, 56(1), 360–367. https://doi.org/10.1080/14017431.2022.2127873

13-year single-center experience with the treatment of acute type B aortic dissection

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Author: Herajärvi, Johanna1,2; Jormalainen, Mikko1; Mustonen, Caius1,2;
Organizations: 1Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland
2Research Unit of Surgery, Anesthesia and Critical Care, University of Oulu, Oulu, Finland
3Department of Radiology, Medical Imaging Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
4Department of Cardiac Surgery, Anesthesia and Intensive Care, Clinica Montevergine, GVM Care and Research, Mercogliano, Italy
5Department of Cardiac Surgery, San Carlo of Nancy Hospital, GVM Care and Research, Rome, Italy
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1.3 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe2022120769775
Language: English
Published: Informa, 2022
Publish Date: 2022-12-07
Description:

Abstract

Background: Acute type B aortic dissection (TBAD) is catastrophic event associated with significant mortality and lifelong morbidity. The optimal treatment strategy of TBAD is still controversial.

Methods: This analysis includes patients treated for TBAD at the Helsinki University Hospital, Finland in 2007–2019. The endpoints were early and late mortality, and intervention of the aorta.

Results: There were 205 consecutive TBAD patients, 59 complicated and 146 uncomplicated patients (mean age of 66 ± 14, females 27.8%). In-hospital and 30-day mortality rates were higher in complicated patients compared with uncomplicated patients with a statistically significant difference (p = 0.035 and p = 0.015, respectively). After a mean follow-up of 4.9 ± 3.8 years, 36 (25.0%) and 22 (37.9%) TBAD -related adverse events occurred in the uncomplicated and complicated groups, respectively (p = 0.066). Freedom from composite outcome was 83 ± 3% and 69 ± 6% at 1 year, 75 ± 4% and 63 ± 7% at 5 years, 70 ± 5% and 59 ± 7% at 10 years in the uncomplicated group and in the complicated group, respectively (p = 0.052). There were 25 (39.1%) TBAD-related deaths in the overall series and prior aortic aneurysm was the only risk factor for adverse aortic-related events in multivariate analysis (HR 3.46, 95% CI 1.72–6.96, p < 0.001).

Conclusion: TBAD is associated with a significant risk of early and late adverse events. Such a risk tends to be lower among patients with uncomplicated dissection, still one fourth of them experience TBAD-related event. Recognition of risk factors in the uncomplicated group who may benefit from early aortic repair would be beneficial.

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Series: Scandinavian cardiovascular journal
ISSN: 1401-7431
ISSN-E: 1651-2006
ISSN-L: 1401-7431
Volume: 56
Issue: 1
Pages: 360 - 367
DOI: 10.1080/14017431.2022.2127873
OADOI: https://oadoi.org/10.1080/14017431.2022.2127873
Type of Publication: A1 Journal article – refereed
Field of Science: 3126 Surgery, anesthesiology, intensive care, radiology
Subjects:
Dataset Reference: Supplemental data for this article can be accessed online at https://doi.org/10.1080/14017431.2022.2127873.
  https://doi.org/10.1080/14017431.2022.2127873
Copyright information: © 2022 The Author(s). This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
  https://creativecommons.org/licenses/by-nc/4.0/