Hybrid versus conventional treatment of acute type A aortic dissection

Fabrizio Settepani, Antioco Cappai, Alessio Basciu, Alessandro Barbone, Enrico Citterio, Diego Ornaghi, Giuseppe Tarelli

Research output: Contribution to journalArticlepeer-review

Abstract

Background To determine whether the hybrid approach to acute type A aortic dissection results in improved outcomes in terms of mortality, neurologic complications, need for distal aortic reintervention, and false lumen thrombosis compared with the conventional approach. Methods Data from comparative studies of hybrid versus conventional treatment of acute type A aortic dissection were combined through meta-analysis. Pooled odd ratios were calculated using random effects models. Results Seven comparative studies including 967 patients were identified; of these, 503 underwent conventional proximal aortic repair and 429 extensive distal aortic repair including a stented elephant trunk technique. Between the two groups there was no significant difference in operative mortality (p = 0.96), permanent neurologic deficit (p = 0.95), and late mortality (p = 0.59). Distal aortic repair showed a higher rate of false lumen thrombosis of the thoracic aorta (odd ratio 11.16; p <0.001) and a reduced risk of distal reintervention (odd ratio 0.37; p = 0.01). In sub-group analysis, frozen elephant trunk procedure showed a lower rate of distal aortic reintervention and a higher rate of false lumen thrombosis than antegrade/retrograde stent deployment techniques (p = 0.008 and

Original languageEnglish
Pages (from-to)707-713
Number of pages7
JournalJournal of Cardiac Surgery
Volume30
Issue number9
DOIs
Publication statusPublished - Sep 1 2015

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

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