Long-term effectiveness of operative procedures for Stanford type A aortic dissections

Reimplantation Valve Sparing Procedure in Type A Aortic Dissection: A Predictive Factor of Mortality and Morbidity?

“…If this surgical treatment brings entire satisfaction in immediate postoperative course, the long term outcome remains controversial. Supracommissural replacement has been proven by some authors inasmuch as the freedom for reoperation for aortic valve dysfunction was elevated after 10 years of follow-up (up to 91%) [Casselman et al, 2000, Driever et al, 2004]. Yet, others underscore that the progression of the disease, regardless to a pre-existing aortic aneurysm, could lead to aortic insufficiency by the absence of coaptation between the three leaflets.…”

Should a reimplantation valve sparing procedure be done systematically in type A aortic dissection?

“…If this surgical treatment brings entire satisfaction in immediate postoperative course, the long-term outcome remains controversial. Supracommissural replacement has been proven by some authors inasmuch as the freedom for reoperation for aortic valve dysfunction was elevated after 10 years of follow-up (up to 91%) [11,12]. Yet, others underscore that the progression of the disease, regardless to a pre-existing aortic aneurysm, could lead to aortic insufficiency by the absence of coaptation between the three leaflets.…”

Diagnosis and Management of Acute Type A Aortic Dissection

“…52 Urbanski et al 53 reported a 4.7% mortality and 7% incidence of neurologic events in their single center experience with total arch replacement. Driever et al 54 showed that there was no long-term survival benefit among the 3 different distal operations (ascending aorta alone, ascending aorta and hemiarch, and total arch replacement). Similar findings were supported by data from Stanford along with an operative mortality of 55% for patients undergoing total arch replacement versus 41% for hemiarch replacement.…”