Long‐term outcomes of total arch replacement versus proximal aortic replacement in acute type A aortic dissection: Meta‐analysis of Kaplan–Meier‐derived individual patient data

Michel Pompeu Sá; Xander Jacquemyn; Panagiotis T. TasoudisJef Van den EyndeOzgun ErtenSerge SicouriAlexander DokollariGianluca TorregrossaStephan KurzSamuel HeutsChristoph A. NienaberJoseph S. CoselliBasel Ramlawi

首页> 外文期刊>Journal of cardiac surgery. >Long‐term outcomes of total arch replacement versus proximal aortic replacement in acute type A aortic dissection: Meta‐analysis of Kaplan–Meier‐derived individual patient data

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Long‐term outcomes of total arch replacement versus proximal aortic replacement in acute type A aortic dissection: Meta‐analysis of Kaplan–Meier‐derived individual patient data

机译：Long‐term outcomes of total arch replacement versus proximal aortic replacement in acute type A aortic dissection: Meta‐analysis of Kaplan–Meier‐derived individual patient data

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Abstract Objectives To evaluate the long‐term outcomes of a conservative approach (with proximal aortic replacement with or without hemiarch replacement) versus an aggressive approach (with total aortic arch replacement) in the treatment of acute type A aortic dissection (ATAAD). Methods We performed a pooled analysis of Kaplan–Meier‐derived individual patient data?from studies with follow‐up comparing the aforementioned approaches to treat patients with ATAAD. Results Eighteen studies met our eligibility criteria, comprising 5243 patients with follow‐up (Conservative: 3676 patients; Aggressive: 1567 patients). We observed a statistically significant difference in overall survival favoring the aggressive approach (hazard ratios?HR 0.86, 95 confidence interval CI?0.76–0.98, p?=?.022), but no statistically significant difference in the risk of reoperation (HR 0.89, 95 CI 0.66–1.2, p?=?.439) in the overall follow‐up. Landmark analyses revealed that, in the first 3 months after the procedure, mortality rates were comparable between conservative and aggressive approaches (HR 1.04, 95?CI 0.88–1.24, p?=?.627), but the results beyond 3 months showed improved survival in patients undergoing the aggressive surgical procedure (HR 0.71, 95?CI 0.59–0.85,?p?

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《Journal of cardiac surgery.》 |2022年第12期|4256-4266|共11页
作者
Michel Pompeu Sá; Xander Jacquemyn; Panagiotis T. TasoudisJef Van den EyndeOzgun ErtenSerge SicouriAlexander DokollariGianluca TorregrossaStephan KurzSamuel HeutsChristoph A. NienaberJoseph S. CoselliBasel Ramlawi;
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Department of Cardiothoracic Surgery, Lankenau Medical Center, Lankenau Heart Institute,Main Line;

Department of Cardiovascular Sciences,KU Leuven;

Department of Cardiothoracic Surgery Research,Lankenau Institute for Medical ResearchDepartment of Cardiothoracic and Vascular Surgery,German Heart Center BerlinDepartment of Cardiothoracic Surgery,Maastricht University Medical CentreCardiology and Aortic Centre,The Royal Brompton & Harefield NHS TrustDepartment of Surgery, Division of Cardiothoracic Surgery,Michael E. DeBakey Baylor College of;

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中图分类心脏血管和淋巴系外科学;
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aortic diseases; cardiac surgical procedures; cardiovascular surgical procedures; endovascular procedures; meta‐analysis; thoracic aorta;

Long‐term outcomes of total arch replacement versus proximal aortic replacement in acute type A aortic dissection: Meta‐analysis of Kaplan–Meier‐derived individual patient data

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