Skip to main content

Surgical treatment of type A Acute Aortic Dissection based on Geneva algorithm

Background/Introduction

Type A Acute Aortic Dissection (AAAD) is a highly deadly disease. Management of AAAD suspicion is extremely important in order to gain time and increase the likelihood of survival.

Aims/Objectives

The aim of this study is to review our experience based on our local algorithm developed for the assessment and management of patients with AAAD suspicion over the last 8 years.

Methods

All patients who underwent an emergency surgery for AAAD between 2007 and 2014 following our algorithm were assessed (Table). Their clinical situation at admission, evaluation, operative and postoperative data were evaluated retrospectively. Continuous variables were expressed as mean ± standard deviation; categorical variables were shown as frequency and percentage.

Results

A total of 68 patients were included during the study period. The mean age was 61 ± 13 years, with 42 men (65%). Supracoronary ascending aorta replacement was the primary surgical procedure (in 31 patients, 46%). The mean cardiopulmonary bypass, cross clamp and circulatory arrest times were 3.2 ± 1.6, 2.1 ± 1.2 and 0.4 ± 0.2 hours. Acute renal failure (27, 40%), re-operation (18, 26%) and pneumonia (14, 20%) were the main postoperative complications. Mean intensive care unit stay and hospitalization times were 5.8 ± 6.2 and 26.5 ± 53.5 days. There were 14 perioperative deaths (21%) and 18 hospital deaths (26%). The 6-year survival was 67.5%.

Conclusion

Our institutional experience in managing AAAD is comparable to results from other centers. Standardizing management using an algorithm is important to gain time for rapid decision-making and having successful outcomes in centers with limited volume.

Figure 1
figure1

Decision Algorithm: Suspicion on Acute Type A Aortic Dissection (AAAD).

Author information

Affiliations

Authors

Corresponding author

Correspondence to Parmeseeven Mootoosamy.

Rights and permissions

Open Access  This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.

The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.

To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/.

The Creative Commons Public Domain Dedication waiver (https://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Depboylu, B.C., Finci, L., Myers, P.O. et al. Surgical treatment of type A Acute Aortic Dissection based on Geneva algorithm. J Cardiothorac Surg 10, A313 (2015). https://doi.org/10.1186/1749-8090-10-S1-A313

Download citation

Keywords

  • Acute Renal Failure
  • Cardiopulmonary Bypass
  • Intensive Care Unit Stay
  • Local Algorithm
  • Limited Volume