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The David Versus the Bentall Procedure for Acute Type A Aortic Dissection
F. Biancari, G. Mastroiacovo, M. Rinaldi, L. Ferrante, T. Mäkikallio, T. Juvonen, G. Mariscalco, Z. El-Dean, M. Pettinari, J. Rodriguez Lega, AG. Pinto, A. Perrotti, F. Onorati, K. Wisniewski, T. Demal, P. Kacer, J. Rocek, D. Di Perna, I....
Status neindexováno Jazyk angličtina Země Švýcarsko
Typ dokumentu časopisecké články
NLK
Directory of Open Access Journals
od 2014
PubMed Central
od 2015
Europe PubMed Central
od 2015
ProQuest Central
od 2021-01-01
Open Access Digital Library
od 2014-01-01
Health & Medicine (ProQuest)
od 2021-01-01
ROAD: Directory of Open Access Scholarly Resources
od 2014
PubMed
39590213
DOI
10.3390/jcdd11110370
Knihovny.cz E-zdroje
- Publikační typ
- časopisecké články MeSH
Background: Type A aortic dissection (TAAD) is a life-threatening condition which requires prompt diagnosis and surgical treatment. When TAAD involves the aortic root, aortic valve-sparing or Bentall procedures are the main surgical treatment options. Method: The subjects of this analysis were 3735 patients included in the European Registry of Type A Aortic Dissection (ERTAAD). Propensity score matching was performed by estimating a propensity score from being treated with the Bentall or the David procedure using multilevel mixed-effects logistics, considering the cluster effect of the participating hospitals. Results: A Bentall procedure was performed in 862 patients, while a David operation was performed in 139 patients. The proportion of aortic root replacement, as well as the different techniques of aortic root replacement, varied significantly between the participating hospitals (p < 0.001). After propensity score matching, we obtained two groups of 115 patients each, and no statistical differences were reported in terms of postoperative outcomes, except for the rate of dialysis, which was higher in the patients requiring a Bentall procedure (17.4% vs. 7.0%, p-value 0.016). In the unmatched cohorts, the David procedure was associated with a lower 10-year mortality rate compared to the Bentall procedure (30.1% vs. 45.6%, p-value 0.004), but no difference was observed after matching (30.0% vs. 43.9%, p-value 0.082). After 10 years, no differences were observed in terms of proximal aortic reoperation (3.9% vs. 4.1%, p-value 0.954), even after propensity score matching (2.8% vs. 1.8%, p-value 0.994). Conclusions: The David and Bentall procedures are durable treatment methods for TAAD. When feasible, it is advisable that the David procedure is performed for acute TAAD by surgeons with experience with this demanding surgical technique.
Cardiac Surgery Molinette Hospital University of Turin 10126 Turin Italy
Cardiothoracic Department Azienda Sanitaria Universitaria Friuli Centrale 33100 Udine Italy
Cardiovascular Surgery Department University Hospital Gregorio Marañón 28007 Madrid Spain
Department of Cardiac Surgery Centre Hospitalier Annecy Genevois 74370 Epagny Metz Tessy France
Department of Cardiac Surgery Cologne University Hospital 50937 Cologne Germany
Department of Cardiac Surgery Glenfield Hospital Leicester LE3 9QP UK
Department of Cardiac Surgery Martin Luther University Halle Wittenberg 06108 Halle Germany
Department of Cardiac Surgery Saint Luc Hospital 1200 Louvain Belgium
Department of Cardiothoracic Surgery University Hospital Muenster 48149 Muenster Germany
Department of Cardiovascular Surgery Centro Cardiologico Monzino IRCCS 20138 Milan Italy
Department of Thoracic and Cardiovascular Surgery University of Franche Comte 25000 Besancon France
Division of Cardiac Surgery University of Verona Medical School 37134 Verona Italy
Faculty of Medicine University of Oulu 90220 Oulu Finland
German Centre for Cardiovascular Research Partner Site Munich Heart Alliance 80336 Munich Germany
Heart and Lung Center Helsinki University Hospital University of Helsinki 00029 Helsinki Finland
Liverpool Heart and Chest Hospital Liverpool L14 3PE UK
Unit of Biostatistics Centro Cardiologico Monzino IRCCS 20138 Milan Italy
Université Paris Est Créteil Inserm IMRB U955 CEpiA Team 94000 Créteil France
Citace poskytuje Crossref.org
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