European registry of type A aortic dissection (ERTAAD) - rationale, design and definition criteria

Abstract

Background Acute Stanford type A aortic dissection (TAAD) is a life-threatening condition. Surgery is usually performed as a salvage procedure and is associated with significant postoperative early mortality and morbidity. Understanding the patient’s conditions and treatment strategies which are associated with these adverse events is essential for an appropriate management of acute TAAD. Methods Nineteen centers of cardiac surgery from seven European countries have collaborated to create a multicentre observational registry (ERTAAD), which will enroll consecutive patients who underwent surgery for acute TAAD from January 2005 to March 2021. Analysis of the impact of patient’s comorbidities, conditions at referral, surgical strategies and perioperative treatment on the early and late adverse events will be performed. The investigators have developed a classification of the urgency of the procedure based on the severity of preoperative hemodynamic conditions and malperfusion secondary to acute TAAD. The primary clinical outcomes will be in-hospital mortality, late mortality and reoperations on the aorta. Secondary outcomes will be stroke, acute kidney injury, surgical site infection, reoperation for bleeding, blood transfusion and length of stay in the intensive care unit. Discussion The analysis of this multicentre registry will allow conclusive results on the prognostic importance of critical preoperative conditions and the value of different treatment strategies to reduce the risk of early adverse events after surgery for acute TAAD. This registry is expected to provide insights into the long-term durability of different strategies of surgical repair for TAAD. Trial registration ClinicalTrials.gov Identifier: NCT04831073.

Current Surgical Management of Acute Type A Aortic Dissection in China

“… 4 , 16 Nineteen centers of cardiac surgery from 7 European countries have collaborated to create a multicenter observational registry-European registry of TAAD. 7 In addition, many large multicenter cardiac surgery or aortic dissection databases also analyze patients with TAAD separately. The Society for Thoracic Surgeons National Adult Cardiac Surgery Database is the largest registry for heart surgery in the world and examines current patient characteristics, predictors, and outcomes for acute TAAD.…”

“… 1 , 2 , 3 Many countries and regions have established multicenter registration studies. 4 , 5 , 6 , 7 The International Registry of Aortic Dissection (IRAD) established in 1996 has published a number of studies that reported a significant impact on the diagnosis and treatment of aortic dissection worldwide. 8 , 9 In 2018, the Registry of Type A Aortic Dissection in China was established in accordance with the model of the International Registration of Aortic Dissection.…”

Surgical Strategy for Repair of Acute Type A Aortic Dissection: A Multicenter Study

“…So, we considered the following status: urgent, emergency grade 1, emergency grade 2, salvage grade 1, and salvage grade. [12]…”

Correction to: European registry of type A aortic dissection (ERTAAD) - rationale, design and definition criteria

“…The original article [ 1 ] erroneously contained copyediting comments in the Methods section which have since been removed.…”