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Archivos de cardiología de México
On-line version ISSN 1665-1731Print version ISSN 1405-9940
Abstract
BORRACCI, Raúl A.; BALDI JR, Julio; YNON, Daniel and RUBIO, Miguel. Current hospital mortality, neurological deficit, and mid-term survival after surgery for acute type A aortic dissection in Argentina. Arch. Cardiol. Méx. [online]. 2018, vol.88, n.5, pp.454-459. Epub Dec 04, 2020. ISSN 1665-1731. https://doi.org/10.1016/j.acmx.2018.05.001.
Objective:
To present the current in-hospital outcomes and mid-term survival of acute type A aortic dissection (AAAD) surgery performed by a group of dedicated high-volume thoracic aortic surgeons in a University Hospital in Argentina.
Methods:
A retrospective analysis of prospectively collected data over a 6-year period (2011---2016) was performed on a consecutive series of 53 adult patients who underwent emer- gency cardiac surgery for AAAD in the Buenos Aires University Hospital in Argentina.
Results:
A mean of 8.8 AAAD repairs were performed yearly during the 6-year period. In-hospital mortality was 17%, and was statistically equivalent to the expected operative mortality rate of 21% (EuroSCORE II) (observed-to-expected mortality ratio 0.81; p = 0.620). New neurological deficit appeared postoperatively in 6% of cases, and the observed major postoperative morbidity rate was 42%. All-cause death cumulative survival probability was 0.711 (SE 0.074), with a mean follow-up period of 49.2 (SE 5.0) months. Cumulative survival probability for in-hospital survivors was 0.903 (SE 0.053), with a mean follow-up period of 62.5 (SE 3.6) months.
Conclusion:
Although the present results do not reach international standards, AAAD surgery in our institution was associated with an acceptable mortality risk and satisfactory mid-term survival compared with previous local studies. In addition to in-hospital mortality, the incidence of new permanent neurological deficit after surgery must be considered the most devastating complication to avoid. Patient-focused care in referral aortic centers with surgery performed by specialized teams should be encouraged in order to improve surgical outcomes in acute aortic dissection surgery in Argentina.
Keywords : Acute type A aortic dissection; Surgery; Mortality; Neurological damage; Survival; Argentina.