Volume 10 Supplement 1

Proceedings of the WSCTS 25th Anniversary Congress

Open Access

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

  • Burak Can Depboylu1,
  • Leon Finci1,
  • Patrick O Myers1,
  • Saziye Karaca1,
  • Dominique Vala1,
  • Jalal Jolou1,
  • Parmeseeven Mootoosamy1,
  • Marck Licker2,
  • Karim Bendjelid3,
  • Afksendiyos Kalangos1 and
  • Mustafa Cikirikcioglu1
Journal of Cardiothoracic Surgery201510(Suppl 1):A313

https://doi.org/10.1186/1749-8090-10-S1-A313

Published: 16 December 2015

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

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

Authors’ Affiliations

(1)
Division of Cardiovascular Surgery, Hospitals and Medical Faculty of Geneva, Geneva
(2)
Division of Anaesthesiology University, Hospitals and Medical Faculty of Geneva, Geneva
(3)
Division of Intensive Care, Hospitals and Medical Faculty of Geneva, Geneva

Copyright

© 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 (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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