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Early Mortality in Type A Acute Aortic Dissection: Insights From the International Registry of Acute Aortic Dissection

Sunday, September 4, 2022

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Source Name: JAMA Cardiololgy


Kevin M. Harris, Christoph A. Nienaber, Mark D. Peterson, Elise M. Woznicki, Alan C. Braverman, Santi Trimarchi, Truls Myrmel, Reed Pyeritz, Stuart Hutchison, Craig Strauss, Marek P. Ehrlich, Thomas G. Gleason, Amit Korach, Daniel G. Montgomery, Eric M. Isselbacher, Kim A. Eagle

This is the most recent data on the early mortality of acute type A aortic dissection within the first forty-eight hours from onset. Prior to this study, there was a lack of contemporary data that characterized the positive effects of timely surgery.

Based on 5611 patients enrolled between January 1996 and November 2018, the IRAD investigators have found an overall mortality of 5.8% over the first forty-eight hours. In medically managed patients, mortality was 23.7% at forty-eight hours (0.5% per hour). For patients intended for surgical treatment, forty-eight-hour mortality was 4.4% (0.09% per hour), and 1% died before the operation. Surgical patients were more likely to die of multiorgan failure and bleeding complications, while medically managed patients were more likely to die of aortic rupture and cardiac tamponade.

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