Outcome of surgery for type A aortic dissection – Twenty year evolution of a single surgeon practice

Results: Ten year study eras included 47 and 45 patients respectively. Era A patients were more likely (91%) to present with good, and era B (35%) moderate, left ventricular function. Incidence of arch replacement, composite root replacement and interposition graft was comparable. Circulatory arrest became less common (91% vs. 82%; p=0.13). Circulatory arrest, CPB and AXC times remained constant. Perfusion strategy shifted from femoral cannulation (89% vs. 24%; p<0.01). Overall mortality was 13% and improved with time (17% vs. 9%; p=0.36). Composite end point of freedom of death, neurological injury and reoperation for bleeding remained similar (66% vs. 69%;p=0.36). Renal complications, tracheostomy, ICU and hospital stay did not alter.