Short and long-term survival in type A aortic dissection justifies the operative risk and effort

Abstract

Abstract Objectives. To evaluate the survival rate and complications after operation for acute aortic dissection type A. Design. Chart review of all consecutive patients with aortic dissection admitted during 1999–2008 (n 99) to Oslo University Hospital Ullevål, Oslo. Results. Thirty-day mortality was 14 patients and late mortality 21 patients. Twenty-nine patients had no postoperative complications. Cerebral affection was seen in 22 patients. Seventy-nine patients were operated on with deep hypothermic circulatory arrest. Mean circulatory arrest time was 23 minutes (range 12–47). Eighty-three of the patients were cannulated through the femoral artery, with a 30-day mortality rate of 17% (n 14) versus 0% for other cannulations (n 16); and a stroke rate of 24% (n 20) versus 17% (n􏰀2) in patients cannulated in the subclavian or axillary artery (no statistically significant difference in either mortality or stroke). Conclusions. Our study confirms that overall mortality and neurological complications are acceptable and the long-term survival rate is good in patients operated on for acute aortic dissection. Circulatory arrest time seems not to affect neurological complications when being relatively short.