One‐Year Functional Outcome of Patients After Surgery for Acute Stanford Type A Aortic Dissection
Background Our aim was to report the functional outcome of Stanford type A aortic dissection (TAAD) after 1 year as well as morbidity and mortality. Methods and Results This is a retrospective analysis including 642 patients with TAAD from January 2005 to December 2021. Mean age at TAAD was 62 years...
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Wiley
2025-02-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.124.036495 |
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| author | Murat Yildiz Maria Nucera Selim Mosbahi Kai Münker Cem Kapkin Silvan Jungi Matthias Siepe Florian Schoenhoff |
| author_facet | Murat Yildiz Maria Nucera Selim Mosbahi Kai Münker Cem Kapkin Silvan Jungi Matthias Siepe Florian Schoenhoff |
| author_sort | Murat Yildiz |
| collection | DOAJ |
| description | Background Our aim was to report the functional outcome of Stanford type A aortic dissection (TAAD) after 1 year as well as morbidity and mortality. Methods and Results This is a retrospective analysis including 642 patients with TAAD from January 2005 to December 2021. Mean age at TAAD was 62 years (95% CI, 61–63), and 30% of the population were women. One year after surgery for TAAD, 75% of patients were living at home with New York Heart Association functional class I. No patients were observed with New York Heart Association functional class IV. Less than 2% resided in an assisted‐living facility. Eighty‐five percent of nonretired patients had returned to work. Two hundred twelve (33%) patients were retired after 1 year at a mean age of 73 years (95% CI, 72–74). Stroke (defined as any kind of neurological symptoms) occurred in 148 (23%) patients and was the cause of death in 33 patients. Of the remaining patients with stroke, 115 (30%) had no residual limitations 1 year after TAAD. The cross‐clamp time was significantly higher in patients with stroke (98 minutes [95% CI, 94.0–101.1] in patients without stroke versus 106 minutes [95% CI, 98.5–114.1] in patients with stroke; P=0.026). Sixty‐nine percent of patients with stroke lived at home, 28% lived at home with support, and 3% lived in an assisted‐living facility. One year after stroke, 77% of the patients achieved a modified Rankin Scale score ≤2, whereas no patient had a modified Rankin Scale score of 5. There was no significant correlation between sex and recovery rate (P=0.48). However, experiencing a stroke significantly increased the likelihood of residing in an assisted‐living facility or receiving support at home 1 year after TAAD (odds ratio, 9.46 [95% CI, 5.06–17.70]; P<0.001). Thirty‐day mortality was 11.8%, and 92 patients (14%) died within the first year after TAAD. There was no significant sex difference in mortality (P=0.101). Conclusions One year after surgery for Stanford acute type A aortic dissection, almost 3 out of 4 patients lived unassisted at home. Stroke survivors have a favorable outcome, with the majority having mild or no residual neurological deficits at 1 year. |
| format | Article |
| id | doaj-art-53e018f470764debb63c01190b58b33d |
| institution | DOAJ |
| issn | 2047-9980 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Wiley |
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| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-53e018f470764debb63c01190b58b33d2025-08-20T03:06:01ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-02-0114410.1161/JAHA.124.036495One‐Year Functional Outcome of Patients After Surgery for Acute Stanford Type A Aortic DissectionMurat Yildiz0Maria Nucera1Selim Mosbahi2Kai Münker3Cem Kapkin4Silvan Jungi5Matthias Siepe6Florian Schoenhoff7Department of Cardiac Surgery, Inselspital Bern University Hospital Bern Bern SwitzerlandDepartment of Cardiac Surgery, Inselspital Bern University Hospital Bern Bern SwitzerlandDepartment of Cardiac Surgery, Inselspital Bern University Hospital Bern Bern SwitzerlandDepartment of Cardiac Surgery, Inselspital Bern University Hospital Bern Bern SwitzerlandDepartment of Cardiac Surgery, Inselspital Bern University Hospital Bern Bern SwitzerlandDepartment of Cardiac Surgery, Inselspital Bern University Hospital Bern Bern SwitzerlandDepartment of Cardiac Surgery, Inselspital Bern University Hospital Bern Bern SwitzerlandDepartment of Cardiac Surgery, Inselspital Bern University Hospital Bern Bern SwitzerlandBackground Our aim was to report the functional outcome of Stanford type A aortic dissection (TAAD) after 1 year as well as morbidity and mortality. Methods and Results This is a retrospective analysis including 642 patients with TAAD from January 2005 to December 2021. Mean age at TAAD was 62 years (95% CI, 61–63), and 30% of the population were women. One year after surgery for TAAD, 75% of patients were living at home with New York Heart Association functional class I. No patients were observed with New York Heart Association functional class IV. Less than 2% resided in an assisted‐living facility. Eighty‐five percent of nonretired patients had returned to work. Two hundred twelve (33%) patients were retired after 1 year at a mean age of 73 years (95% CI, 72–74). Stroke (defined as any kind of neurological symptoms) occurred in 148 (23%) patients and was the cause of death in 33 patients. Of the remaining patients with stroke, 115 (30%) had no residual limitations 1 year after TAAD. The cross‐clamp time was significantly higher in patients with stroke (98 minutes [95% CI, 94.0–101.1] in patients without stroke versus 106 minutes [95% CI, 98.5–114.1] in patients with stroke; P=0.026). Sixty‐nine percent of patients with stroke lived at home, 28% lived at home with support, and 3% lived in an assisted‐living facility. One year after stroke, 77% of the patients achieved a modified Rankin Scale score ≤2, whereas no patient had a modified Rankin Scale score of 5. There was no significant correlation between sex and recovery rate (P=0.48). However, experiencing a stroke significantly increased the likelihood of residing in an assisted‐living facility or receiving support at home 1 year after TAAD (odds ratio, 9.46 [95% CI, 5.06–17.70]; P<0.001). Thirty‐day mortality was 11.8%, and 92 patients (14%) died within the first year after TAAD. There was no significant sex difference in mortality (P=0.101). Conclusions One year after surgery for Stanford acute type A aortic dissection, almost 3 out of 4 patients lived unassisted at home. Stroke survivors have a favorable outcome, with the majority having mild or no residual neurological deficits at 1 year.https://www.ahajournals.org/doi/10.1161/JAHA.124.036495aortaaortic dissectionfunctional outcomestroke |
| spellingShingle | Murat Yildiz Maria Nucera Selim Mosbahi Kai Münker Cem Kapkin Silvan Jungi Matthias Siepe Florian Schoenhoff One‐Year Functional Outcome of Patients After Surgery for Acute Stanford Type A Aortic Dissection Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease aorta aortic dissection functional outcome stroke |
| title | One‐Year Functional Outcome of Patients After Surgery for Acute Stanford Type A Aortic Dissection |
| title_full | One‐Year Functional Outcome of Patients After Surgery for Acute Stanford Type A Aortic Dissection |
| title_fullStr | One‐Year Functional Outcome of Patients After Surgery for Acute Stanford Type A Aortic Dissection |
| title_full_unstemmed | One‐Year Functional Outcome of Patients After Surgery for Acute Stanford Type A Aortic Dissection |
| title_short | One‐Year Functional Outcome of Patients After Surgery for Acute Stanford Type A Aortic Dissection |
| title_sort | one year functional outcome of patients after surgery for acute stanford type a aortic dissection |
| topic | aorta aortic dissection functional outcome stroke |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.124.036495 |
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