Current status of treatment for the acute type A aortic dissection in Japan.

IF 2.6 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Seminars in Thoracic and Cardiovascular Surgery Pub Date : 2025-03-12 DOI:10.1053/j.semtcvs.2025.02.008

Yutaka Okita

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引用次数: 0

Abstract

Objective: Presenting the current status of patient outcomes with acute type A aortic dissection in Japan.

Methods: The JATS, JROAD, JRAD, JCVSD, NCD, The Tokyo acute aortic super network, and J-ORCHESTRA database were used.

Results: The incidence of AAD ranged from 10 to 20 per 100,000 population. Thirty per cent of patients were older than 70 years. Malperfusion syndrome or ruptured aorta was found in 10 to 20%. Over 90 % of patients had surgery within 24 hours after diagnosis. The mortality tended to be higher in the super-acute phases from onset to surgical treatment. Acute organ malperfusion requires an accurate and prompt diagnosis to proceed with an appropriate intervention before repairing the central aorta. Antegrade cerebral perfusion was used in 70 to 80 % and deep hypothermic circulatory arrest with/without retrograde cerebral perfusion in 20 to 30%. High-moderate or mild hypothermia was applied in more than 50% of patients. Replacement of the ascending aorta was performed in 70% and total arch replacement in 30%. Treatment with frozen elephant trunk as well as TEVAR has increased. The aortic valve was replaced in 8 - 10%. Thirty-day mortality was 9.0 % to 10 %. The number of operations has increased over time. Stroke occurred in 10% to 12%.

Conclusion: Although the early outcomes are acceptable, there is still room to be improved in patients with preoperative comorbidities.

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来源期刊

Seminars in Thoracic and Cardiovascular Surgery Medicine-Pulmonary and Respiratory Medicine

CiteScore

5.80

自引率

0.00%

发文量

324

审稿时长

12 days

期刊介绍： Seminars in Thoracic and Cardiovascular Surgery is devoted to providing a forum for cardiothoracic surgeons to disseminate and discuss important new information and to gain insight into unresolved areas of question in the specialty. Each issue presents readers with a selection of original peer-reviewed articles accompanied by editorial commentary from specialists in the field. In addition, readers are offered valuable invited articles: State of Views editorials and Current Readings highlighting the latest contributions on central or controversial issues. Another prized feature is expert roundtable discussions in which experts debate critical questions for cardiothoracic treatment and care. Seminars is an invitation-only publication that receives original submissions transferred ONLY from its sister publication, The Journal of Thoracic and Cardiovascular Surgery. As we continue to expand the reach of the Journal, we will explore the possibility of accepting unsolicited manuscripts in the future.

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