Original articleCardiovascularLong-Term Results After 27 Years of Surgical Treatment of Acute Type A Aortic Dissection
Section snippets
Material and Methods
Between November 1974 and December 2001, 315 consecutive patients (205 men and 110 women) were operated on for acute type A aortic dissection at the St. Antonius Hospital, Nieuwegein, The Netherlands. The mean patient age was 58 ± 12 years. If chest pain or other symptoms occurred less than 14 days before operation, the dissection was defined as acute [5]. The type of the aortic dissection was considered, according to the Stanford classification, to be type A if the ascending aorta was involved
Survival
The overall operative mortality rate was 22.9%; 243 patients survived surgical treatment and were discharged from the hospital. Among the discharged patients, cumulative survival was 96.4% ± 1.3%, 67.7% ± 4.7%, and 39.4% ± 12.0% at 1, 10, and 20 years, respectively (Fig 1). Median survival time was 16.0 years. During the follow-up period, 47 patients died (19.3%). Seven patients died of cardiac failure, 7 patients had fatal rupture of the distal aorta, and 4 patients died of a stroke (Table 1).
Comment
We have reviewed the late results for 243 discharged patients who survived surgical treatment for acute type A dissection. The results indicate that the variables found to influence the long-term results were all associated with preoperative patient-related factors and with a certain seriousness and extent of the disease, which for the most part cannot be readily modified. This is similar to previous reports in which late results were shown to depend upon both technical features of the
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