Investigation of factors affecting reintervention after type A aortic dissection

Abstract

Aim: Our study aims to share the reintervention results of patients who were operated with the diagnosis of Type A aortic dissection and to examine the factors that cause reintervention. Material and Methods: In our single-center retrospective study, 244 patients who underwent surgery due to Type A aortic dissection between November 2010 and June 2021 were included. Results for patients who underwent reintervention and factors which caused reintervention were compared with demographic data, preoperative, intraoperative and postoperative variables. Results: A total of 142 patients were included in the study and 15.5% of them underwent reintervention. Reoperation was performed in 8 (36.4%) of 22 patients who underwent reintervention, while thoracic aortic endovascular repair was performed in 14 (63.6%) patients. Post-procedure mortality was observed in 5 (22.7%) of the patients who underwent reintervention. The mean age of the patients who underwent reintervention was 46.6±13.2 and there was a statistically significant (p<0.05) difference between the groups (p: 0.026). Results that were significant for reintervention were multivariate analysis with cox regression and it was shown that the persistence of postoperative hypertension with total arch surgery was a risk factor for reintervention (p: 0.03, p: 0.008). Conclusion: Type A aortic dissection is not considered to be completely cured after the first operation. It is necessary to evaluate the patients in terms of reintervention with close follow-up. We propose that patients who underwent total arch surgery during the first operation and hypertension in the postoperative period are risk factors for reintervention.