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

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Journal of Cardiothoracic Surgery201510 (Suppl 1) :A313

  • Published:


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


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.


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.


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.


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%.


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
Figure 1

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

Authors’ Affiliations

Division of Cardiovascular Surgery, Hospitals and Medical Faculty of Geneva, Geneva, Geneva, 1211, Switzerland
Division of Anaesthesiology University, Hospitals and Medical Faculty of Geneva, Geneva, Geneva, 1211, Switzerland
Division of Intensive Care, Hospitals and Medical Faculty of Geneva, Geneva, Geneva, 1211, Switzerland


© Depboylu et al. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.