BACKGROUND: Data on the prognostic impact of type A aortic dissection involving the common carotid arteries (CCAs) are scarce. METHODS: Data on the status of the CCAs were available in 1106 patients who underwent surgery for acute DeBakey type 1 aortic dissection who were recruited in a retrospective, multicentre European registry, that is, the ERTAAD. Postoperative neurological complications were defined as ischaemic stroke, haemorrhagic stroke and/or global brain ischaemia. RESULTS: Patients without carotid artery dissection, those with unilateral or bilateral CCA dissection had in-hospital mortality rates of 19.5%, 16.9% (OR 1.006, 95% CI 0.614 to 1.647) and 27.3% (p<0.001, OR 1.719, 95% CI 1.086 to 2.722), respectively. Bilateral, but not unilateral, dissection of the CCAs increased the risk of neurological complications (40.0% vs 18.9%, OR 2.453, 95% CI 1.683 to 3.576). The negative prognostic effect of bilateral dissection of the CCAs was increased among patients without cerebral malperfusion who underwent surgery with the use of hypothermic circulatory arrest (28.7% vs 4.3%, p=0.014). CONCLUSIONS: Bilateral, but not unilateral, dissection of the CCAs may increase the risk of neurological complications and in-hospital mortality after surgery for DeBakey type 1 aortic dissection. TRIAL REGISTRATION NUMBER: NCT04831073.

• Keywords
• Aneurysm, Dissecting, Cardiac Surgical Procedures, Carotid Artery Diseases, STROKE,
• MeSH
• Aortic Aneurysm, Thoracic * surgery   mortality   MeSH
• Carotid Artery, Common * diagnostic imaging   surgery   MeSH
• Aortic Dissection * surgery   diagnosis   mortality   complications   MeSH
• Risk Assessment MeSH
• Middle Aged MeSH
• Humans MeSH
• Hospital Mortality trends   MeSH
• Follow-Up Studies MeSH
• Carotid Artery Diseases * MeSH
• Postoperative Complications * epidemiology   etiology   MeSH
• Prognosis MeSH
• Registries MeSH
• Retrospective Studies MeSH
• Risk Factors MeSH
• Aged MeSH
• Vascular Surgical Procedures * adverse effects   MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH
• Observational Study MeSH
• Geographicals
• Europe epidemiology   MeSH