Acute type A aortic syndromes and ski: management in an emergency care network.

Background: Skiing can cause aortic syndromes. The pre-hospital management of these patients may be compromised by the mountainous terrain. A regional emergency care network helps to optimize time frames, especially in a challenging geography. We compared the characteristics of patients operated for acute type A aortic syndromes (ATAAS) that occurred while skiing with those that did not.

Methods: Monocentric retrospective observational study of patients operated for ATAAS from 01/01/1990 to 31/12/2019. Five hundred and twenty-three patients were included. Data were compared between skiers and non-skiers.

Results: Thirty-seven (7.1%) patients suffered from an acute type A aortic syndrome while skiing. Skiers were more often male (89.2% vs. 69.1%, P=0.017), younger (54.4±10.9 years vs. 63.5±13.0 years, P<0.001) and taller (175.9±8.1 cm vs. 171.6±9.4 cm, P=0.003). They were more often transported by helicopter (16.2% vs. 6.8%, P=0.048) and had less often isolated supra-coronary aortic replacements (51.4% vs. 71.6%, P=0.029). Skiing-related aortic syndromes were more frequent in patients not living in mountainous regions (70.3% vs. 20.4%, P<0.001). Hospital mortality in skiers was comparable to the one in non-skiers (8.1% vs. 19.3%, P=0.122).

Conclusions: People not acclimatized to high mountain conditions may be at greater risk of aortic syndrome while skiing. Our regional emergency care network facilitates rapid transfer of patients with increased use of helicopter transport for skiers, thereby limiting the mortality of skiing-related aortic syndromes.