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2. Long-term outcomes after recurrent acute thoracic aortic dissection: Insights from the International Registry of Aortic Dissection

Author

Ogami, Takuya, Arnaoutakis, George J., Isselbacher, Eric M., Geuzebroek, Guillaume S.C., Coselli, Joseph S., De Vincentiis, Carlo, Kaiser, Clayton A., Hutchison, Stuart, Li, Qing-Guo, Brinster, Derek R., Leshnower, Bradley G., Serna-Gallegos, Derek, Pai, Chih-Wen, Taylor, Bradley S., Patel, Himanshu J., Eagle, Kim A., and Sultan, Ibrahim

Published
2025
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3. Survival after operative repair of acute type A aortic dissection varies according to the presence and type of preoperative malperfusion

Author

Wolfe, Stanley B., Sundt, Thoralf M., III, Isselbacher, Eric M., Cameron, Duke E., Trimarchi, Santi, Bekeredjian, Raffi, Leshnower, Bradley, Bavaria, Joseph E., Brinster, Derek R., Sultan, Ibrahim, Pai, Chih-Wen, Kachroo, Puja, Ouzounian, Maral, Coselli, Joseph S., Myrmel, Truls, Pacini, Davide, Eagle, Kim, Patel, Himanshu J., and Jassar, Arminder S.

Published
2024
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4. Collagen-Based Bailout Compared to Suture-Mediated Vascular Closure Alone During Transcatheter Aortic Valve Replacement

Author

Basman, Craig, Kodra, Arber, Mustafa, Ahmad, Wang, Denny, Cinelli, Michael, Onyebeke, Kenenna, Rutkin, Bruce, Mehla, Priti, Maniatis, Gregory, Pirelli, Luigi, Goldberg, Ythan, Liu, Shangyi, Uttar, Sridhar, Wilson, Sean, Kalimi, Robert, Brinster, Derek, Gandotra, Puneet, Koss, Elana, Meraj, Perwaiz, Mihelis, Efstathia, Supariwala, Azhar, Hartman, Alan, Scheinerman, S. Jacob, and Kliger, Chad

Published
2024
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8. Editor's Choice – Trends in Management and Outcomes of Type B Aortic Dissection: A Report From the International Registry of Aortic Dissection

Author

Trimarchi, Santi, Gleason, Tom G., Brinster, Derek R., Bismuth, Jean, Bossone, Eduardo, Sundt, Thoralf M., Montgomery, Daniel G., Pai, Chih-Wen, Bissacco, Daniele, de Beaufort, Hector W.L., Bavaria, Joseph E., Mussa, Firas, Bekeredjian, Raffi, Schermerhorn, Marc, Pacini, Davide, Myrmel, Truls, Ouzounian, Maral, Korach, Amit, Chen, Edward P., Coselli, Joseph S., Eagle, Kim A., and Patel, Himanshu J.

Published
2023
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9. Aortic valve versus root surgery after failed transcatheter aortic valve replacement

Author

Saha, Shekhar, Hagl, Christian, Kiefer, Philipp, Holzhey, David, Noack, Thilo, Borger, Michael A., Desai, Nimesh D., Bavaria, Joseph E., Voisine, MDPierre, Mohammadi, Siamak, Rodés-Cabau, Josep, Harrington, Katherine B., Squiers, John J., Szerlip, Molly I., DiMaio, J. Michael, Mack, Michael J., Rovin, Joshua, Gennari, Marco, Fukuhara, Shinichi, Deeb, G. Michael, Sengupta, Aditya, Demers, Philippe, Ibrahim, Reda, Wyler von Ballmoos, Moritz, Atkins, Marvin D., Kleiman, Neal S., Reardon, Michael J., Maisano, Francesco, Bhadra, Oliver D., Conradi, Lenard, Shults, Christian, Satler, Lowell F., Waksman, Ron, Pirelli, Luigi, Brinster, Derek R., Algadheeb, Muhanad, Chu, Michael W.A., Bagur, Rodrigo, Ramlawi, Basel, Grubb, Kendra J., Robinson, Newell B., Wang, Lin, Petrossian, George A., Leroux, Lionel, Doty, John R., Whisenant, Brian K., Kempfert, Joerg, Unbehaun, Axel, Rahim, Hussein, Nazif, Tamim M., George, Isaac, Geirsson, Arnar, Forrest, John K., Vincent, Flavien, Van Belle, Eric, Koussa, Mohamad, Goldberg, Joshua B., Ahmad, Hasan A., Ben Ali, Walid, Andreas, Martin, Werner, Paul, Goel, Kashish, Shah, Ashish S., Gelpi, Guido, Ruel, Marc, Al-Atassi, Talal, Van Mieghem, Nicholas M., Hokken, Thijmen W., D'Onofrio, Augusto, Tessari, Chiara, Hirji, Sameer, Shah, Pinak B., Belluschi, Igor, Garatti, Andrea, Bruschi, Giuseppe, Ouzounian, Maral, Pizano, Alejandro, Di Eusanio, Marco, Capestro, Filippo, Taramasso, Maurizio, Colli, Andrea, Estevez-Loureiro, Rodrigo, Pinon, Miguel A., Salinger, Michael H., Di Virgilio, Antonio, Nguyen, Tom C., Lange, Rudiger, Vitanova, Keti, Zaid, Syed, Tang, Gilbert H.L., Kaneko, Tsuyoshi, Bapat, Vinayak N., Modine, Thomas, and Denti, Paolo

Published
2023
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10. Surgical Explantation of Failed Transcatheter Aortic Valve Replacement

Author

Saha, Shekhar, Kiefer, Philipp, Holzhey, David, Noack, Thilo, Voisine, Pierre, Mohammadi, Siamak, Harrington, Katherine B., Squiers, John J., Fukuhara, Shinichi, von Ballmoos, Moritz Wyler, Goel, Sachin S., Atkins, Marvin D., Bhadra, Oliver D., Conradi, Lenard, Shults, Christian, Satler, Lowell F., Pirelli, Luigi, Brinster, Derek R., Algadheeb, Muhanad, Chu, Michael W.A., Bagur, Rodrigo, Ramlawi, Basel, Grubb, Kendra J., Desai, Nimesh D., Robinson, Newell B., Wang, Lin, Petrossian, George A., Leroux, Lionel, Doty, John R., Kempfert, Joerg, Unbehaun, Axel, Rahim, Hussein, Geirsson, Arnar, Forrest, John K., Vincent, Flavien, Van Belle, Eric, Koussa, Mohamad, Goldberg, Joshua B., Ahmad, Hasan A., Ben Ali, Walid, Demers, Philippe, Ibrahim, Reda, Andreas, Martin, Werner, Paul, Goel, Kashish, Shah, Ashish S., Gelpi, Guido, Ruel, Marc, Al-Atassi, Talal, Van Mieghem, Nicholas M., Hokken, Thijmen W., D'Onofrio, Augusto, Tessari, Chiara, Shah, Pinak B., Belluschi, Igor, Garatti, Andrea, Bruschi, Giuseppe, Ouzounian, Maral, Pizano, Alejandro, Di Eusanio, Marco, Capestro, Filippo, Rovin, Joshua, Taramasso, Maurizio, Gennari, Marco, Colli, Andrea, Estevez-Loureiro, Rodrigo, Pinon, Miguel A., Salinger, Michael H., Di Virgilio, Antonio, Whisenant, Brian K., Nazif, Tamim M., Kleiman, Neal S., Szerlip, Molly I., Waksman, Ron, Rodés-Cabau, Josep, George, Isaac, DiMaio, J. Michael, Maisano, Francesco, Deeb, G. Michael, Vitanova, Keti, Lange, Rudiger, Borger, Michael A., Hagl, Christian, Bavaria, Joseph E., Zaid, Syed, Hirji, Sameer A., Bapat, Vinayak N., Denti, Paolo, Modine, Thomas, Nguyen, Tom C., Mack, Michael J., Reardon, Michael J., Kaneko, Tsuyoshi, and Tang, Gilbert H.L.

Published
2023
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13. Abstract 13748: Safety and Efficacy of Extended Endovascular Treatment for Acute Type B Aortic Dissection: Insights From the International Registry of Acute Aortic Dissection

Author

Allievi, Sara, Trimarchi, Santi, Coselli, Joseph S, Sultan, Ibrahim, Brinster, Derek R, Bavaria, Joseph E, Leshnower, Bradley G, Kachroo, Puja, Jassar, Arminder, Bekeredjian, Raffi, pai, Chih Wen, Pacini, Davide, Myrmel, Truls, Eagle, Kim A, Patel, Himanshu J, and Schermerhorn, Marc

Published
2023
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23. Surgical Explantation After TAVR Failure: Mid-Term Outcomes From the EXPLANT-TAVR International Registry

Author

Sengupta, Aditya, Holzhey, David, Noack, Thilo, Harrington, Katherine B., Mohammadi, Siamak, Brinster, Derek R., Atkins, Marvin D., Algadheeb, Muhanad, Bagur, Rodrigo, Desai, Nimesh D., Bhadra, Oliver D., Conradi, Lenard, Shults, Christian, Satler, Lowell F., Ramlawi, Basel, Robinson, Newell B., Wang, Lin, Petrossian, George A., Andreas, Martin, Werner, Paul, Garatti, Andrea, Vincent, Flavien, Van Belle, Eric, Juthier, Francis, Leroux, Lionel, Doty, John R., Goldberg, Joshua B., Ahmad, Hasan A., Goel, Kashish, Shah, Ashish S., Geirsson, Arnar, Forrest, John K., Grubb, Kendra J., Hirji, Sameer, Shah, Pinak B., Bruschi, Giuseppe, Gelpi, Guido, Belluschi, Igor, Ouzounian, Maral, Ruel, Marc, Al-Atassi, Talal, Kempfert, Joerg, Unbehaun, Axel, Van Mieghem, Nicholas M., Hokken, Thijmen W., Ben Ali, Walid, Ibrahim, Reda, Demers, Philippe, Pizano, Alejandro, Di Eusanio, Marco, Capestro, Filippo, Estevez-Loureiro, Rodrigo, Pinon, Miguel A., Salinger, Michael H., Rovin, Joshua, D'Onofrio, Augusto, Tessari, Chiara, Di Virgilio, Antonio, Taramasso, Maurizio, Gennari, Marco, Colli, Andrea, Whisenant, Brian K., Nazif, Tamim M., Kleiman, Neal S., Szerlip, Molly Y., Waksman, Ron, George, Isaac, Nguyen, Tom C., Maisano, Francesco, Deeb, G. Michael, Bavaria, Joseph E., Reardon, Michael J., Mack, Michael J., Bapat, Vinayak N., Brinkman, William T., DiMaio, J. Michael, George, Timothy J., Potluri, Srinivasa, Ryan, William H., Schaffer, Justin M., Smith, Robert L., III, Squiers, John J., Szerlip, Molly, Kaneko, Tsuyoshi, Nazif, Tamim, Rahim, Hussein, Grubb, Kendra, Atkins, Marvin, Goel, Sachin, Kleiman, Neal, Reardon, Michael, Wyler von Ballmoos, Moritz, Doty, John, Whisenant, Brian, Salinger, Michael, Satler, Lowell, Schults, Christian, Fisher, Susan, Alexis, Sophia L., Tang, Gilbert H.L., Kliger, Chad A., Pirelli, Luigi, Rutkin, Bruce, Yu, Pey-Jen, Petrossian, George, Robinson, Newell, Deeb, Michael, Fukuhara, Shinichi, Oakley, Jessica, Bavaria, Joseph, Desai, Nimesh, Walsh, Lisa, Nguyen, Tom, Ahmad, Hasan, Goldberg, Joshua, Spielvogel, David, Zaid, Syed, Forrest, John, Chu, Michael, Cartier, Raymond, Rodes-Cabau, Josep, Voisine, Pierre, Abois, Alain-Philippe, Boodhwani, Munir, Dick, Alexander, Glover, Christopher, Labinaz, Marino, Lam, Buu-Khanh, Modine, Thomas, Delhaye, Cedric, Delsaux, Adeline, Denimal, Tom, Gaul, Anaïs, Koussa, Mohammad, Pamart, Thibault, Sonnabend, Svetlana, Krane, Markus, Lange, Rudiger, Munsterer, Andrea, Vitanova, Keti, Borger, Michael, Kiefer, Philippe, Hagl, Christian, Saha, Shekhar, Bhadra, Oliver, Conradi, Len, Merlanti, Bruno, Russo, Claudio F., Romagnoni, Claudia, Denti, Paolo, Van Mieghem, Nicholas, Pinnon, Miguel, Kiefer, Philipp, von Ballmoos, Moritz Wyler, Chu, Michael W.A., Rodés-Cabau, Josep, and Borger, Michael A.

Published
2021
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24. Acute Aortic Dissection: Observational Lessons Learned From 11 000 Patients.

Author

Bossone, Eduardo, Eagle, Kim A., Nienaber, Christoph A., Trimarchi, Santi, Patel, Himanshu J., Gleason, Thomas G., Chih-Wen Pai, Montgomery, Daniel G., Pyeritz, Reed E., Evangelista, Arturo, Braverman, Alan C., Brinster, Derek R., Gilon, Dan, Di Eusanio, Marco, Ehrlich, Marek P., Harris, Kevin M., Myrmel, Truls, and Isselbacher, Eric M.

Abstract

BACKGROUND: Over the past 25 years, diagnosis and therapy for acute aortic dissection (AAD) have evolved. We aimed to study the effects of these iterative changes in care. METHODS: Patients with nontraumatic AAD enrolled in the International Registry of Acute Aortic Dissection (61 centers; 15 countries) were divided into time-based tertiles (groups) from 1996 to 2022. The impact of changes in diagnostics, therapeutic care, and in-hospital and 3-year mortality was assessed. Cochran-Armitage trend and Jonckheere-Terpstra tests were conducted to test for any temporal trend. RESULTS: Each group consisted of 3785 patients (mean age, ≈62 years old; ≈65.5% males); nearly two-thirds had type A AAD. Over time, the rates of hypertension increased from 77.8% to 80.4% (P=0.002), while smoking (34.1% to 30.6%, P=0.033) and atherosclerosis decreased (25.6%-16.6%; P<0.001). Across groups, the percentage of surgical repair of type A AAD increased from 89.1% to 92.5% (P<0.001) and was associated with decreased hospital mortality (from 24.1% in group 1 to 16.7% in group 3; P<0.001). There was no difference in 3-year survival (P=0.296). For type B AAD, stent graft therapy (thoracic endovascular aortic repair) was used more frequently (22.3%-35.9%; P<0.001), with a corresponding decrease in open surgery. Endovascular in-hospital mortality decreased from 9.9% to 6.2% (P=0.003). As seen with the type A AAD cohort, overall 3-year mortality for patients with type B AAD was consistent over time (P=0.084). CONCLUSIONS: Over 25 years, substantial improvements in-hospital survival were associated with a more aggressive surgical approach for patients with type A AAD. Open surgery has been partially supplanted by thoracic endovascular aortic repair for complicated type B AAD, and in-hospital mortality has decreased over the time period studied. Postdischarge survival for up to 3 years was similar over time. [ABSTRACT FROM AUTHOR]

Published
2024
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25. Subclavian-Axillary Access for Transcatheter Aortic Valve Implantation with SAPIEN 3: Results from the ACCESS Study

Author

Dahle, Thom G., Stegman, Brian M., Dutcher, Jacob R., Schmidt, Wade T., Danielson, Daren S., Teskey, John M., Reed, Michael C., Long, Stewart M., III, Kliger, Chad A., Brinster, Derek R., Kaneko, Tsuyoshi, Shah, Pinak B., Nores, Marcos A., Rothenberg, Mark D., Chawla, Atul, McAllister, David W., Dezell, Sara J., and Castro, Nathaniel J.

Published
2020
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28. Complete 2-Year Results Confirm Bayesian Analysis of the SURTAVI Trial

Author

Sorajja, Paul, Sun, Benjamin, Agarwal, Himanshu, Langdon, Thomas, den Heijer, Peter, Bentala, Mohamed, O’Hair, Daniel, Bajwa, Tanvir, Byrne, Timothy, Caskey, Michael, Paulus, Basil, Garrett, Edward, Jr., Stoler, Robert, Hebeler, Robert, Popma, Jeffrey J., Khabbaz, Kamal, Lim, David Scott, Bladergroen, Mark, Fail, Peter, Feinberg, Edgar, II, Rinaldi, Michael, Skipper, Eric, Chawla, Atul, Hockmuth, David, Makkar, Raj, Cheng, Wen, Kodali, Susheel, George, Isaac, Aji, Janah, Bowen, Frank, Schreiber, Theodore, Henry, Scott, Hengstenberg, Christian, Bleiziffer, Sabine, Harrison, J. Kevin, Hughes, Chad, Joye, James, Gaudiani, Vincent, Babaliaros, Vasilis, Thourani, Vinod, van Mieghem, Nicolas, Kappetein, A. Pieter, Dauerman, Harold, Schmoker, Joseph, Skelding, Kimberly, Casale, Alfred, Kovac, Jan, Spyt, Tomasz, Seshiah, Puvi, Smith, J. Michael, McKay, Raymond, Hagberg, Robert, Matthews, Ray, Starnes, Vaughn, O’Neill, William, Paone, Gaetano, Hernandez García, Jose Maria, Such, Miguel, Morís de la Tassa, Cesar, Llosa Cortina, Juan Carlos, Windecker, Stephan, Carrel, Thierry, Whisenant, Brian, Doty, John, Resar, Jon, Conte, John, Aharonian, Vicken, Pfeffer, Thomas, Rück, Andreas, Corbascio, Matthias, Blackman, Daniel, Kaul, Pankaj, Kliger, Chad, Brinster, Derek, Teefy, Patrick, Kiaii, Bob, Leya, Ferdinand, Bakhos, Mamdouh, Sandhu, Gurpreet, Pochettino, Alberto, Piazza, Nicolo, de Varennes, Benoit, van Boven, Ad, Boonstra, Piet, Waksman, Ron, Bafi, Ammar, Asgar, Anita, Cartier, Raymond, Kipperman, Robert, Brown, John, Lin, Lang, Rovin, Joshua, Sharma, Samin, Adams, David, Katz, Stanley, Hartman, Alan, Al-Jilaihawi, Hasanian, Williams, Mathew, Crestanello, Juan, Lilly, Scott, Ghani, Mohammad, Bodenhamer, Robert Mark, Rajagopal, Vivek, Kauten, James, Mumtaz, Mumbashir, Bachinsky, Williams, Nickenig, Georg, Welz, Armin, Søndergaard, Lars, Olsen, Peter Skov, Yakubov, Steven, Watson, Daniel, Chhatriwalla, Adnan, Allen, Keith, Teirstein, Paul, Tyner, Jeffrey, Mahoney, Paul, Newton, Joseph, Merhi, William, Keiser, John, Yeung, Alan, Miller, Craig, ten Berg, Jurriën, Heijmen, Robin, Petrossian, George, Robinson, Newell, Brecker, Stephen, Jahangiri, Marjan, Davis, Thomas, Batra, Sanjay, Hermiller, James, Heimansohn, David, Radhakrishnan, Sam, Fremes, Stephen, Maini, Brijeshwar, Bethea, Brian, Brown, David, Ryan, William, Reardon, Michael, Kleiman, Neal, Spies, Christian, Lau, Jeffrey, Herrmann, Howard, Bavaria, Joseph, Horlick, Eric, Feindel, Chris, Neumann, Franz-Josef, Beyersdorf, Friedhelm, Binder, Roland, Maisano, Francesco, Costa, Marco, Markowitz, Alan, Tadros, Peter, Zorn, George, III, de Marchena, Eduardo, Salerno, Tomas, Chetcuti, Stanley, Deeb, G. Michael, Labinz, Marino, Ruel, Marc, Sup Lee, Joon, Gleason, Thomas, Ling, Frederick, Knight, Peter, Robbins, Mark, Ball, Stephen, Giacomini, John, Burdon, Thomas, Applegate, Robert, Kon, Neal, Schwartz, Richard, Schubach, Scott, Forrest, John, Mangi, Abeel, Van Mieghem, Nicolas M., Yakubov, Steven J., Serruys, Patrick W., Mumtaz, Mubashir, Gada, Hemal, Kleiman, Neal S., Oh, Jae K., Kappetein, Arie Pieter, Chang, Yanping, Mugglin, Andrew S., and Reardon, Michael J.

Published
2020
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29. Open, endovascular or hybrid repair of aortic arch disease: narrative review of diverse strategies with diverse options.

Author

Takayama, Hiroo, Hohri, Yu, Brinster, Derek R, Chen, Edward P, El-Hamamsy, Ismail, Elmously, Adham, Derose, Joseph J, Hisamoto, Kazuhiro, Lau, Christopher, Okita, Yutaka, Peterson, Mark D, Spielvogel, David, Youdelman, Benjamin A, and Pacini, Davide

Subjects
ENDOVASCULAR aneurysm repair, THORACIC aorta, ENDOVASCULAR surgery
Abstract

OBJECTIVES The management of aortic arch disease is complex. Open surgical management continues to evolve, and the introduction of endovascular repair is revolutionizing aortic arch surgery. Although these innovative techniques have generated the opportunity for better outcomes in select patients, they have also introduced confusion and uncertainty regarding best practices. METHODS In New York, we developed a collaborative group, the New York Aortic Consortium, as a means of cross-linking knowledge and working together to better understand and treat aortic disease. In our meeting in May 2023, regional aortic experts and invited international experts discussed the contemporary management of aortic arch disease, differences in interpretation of the available literature and the integration of endovascular technology into disease management. We summarized the current state of aortic arch surgery in this review article. RESULTS Approaches to aortic arch repair have evolved substantially, whether it be methods to reduce cerebral ischaemia, improve haemostasis, simplify future operations or expand options for high-risk patients with endovascular approaches. However, the transverse aortic arch remains challenging to repair. Among our collaborative group of cardiac/aortic surgeons, we discovered a wide disparity in our practice patterns and our management strategies of patients with aortic arch disease. CONCLUSIONS It is important to build unique institutional expertise in the context of complex and evolving management of aortic arch disease with open surgery, endovascular repair and hybrid approaches, tailored to the risk profiles and anatomical specifics of individual patients. [ABSTRACT FROM AUTHOR]

Published
2024
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46. Factor eight inhibiting bypass activity for refractory bleeding in acute type A aortic dissection repair: A propensity‐matched analysis.

Author

Pupovac, Stevan S., Levine, Randy, Giammarino, Ashley T., Scheinerman, Samuel Jacob, Hartman, Alan R., Brinster, Derek R., and Hemli, Jonathan M.

Abstract

Background: Perioperative bleeding and transfusion have been associated with adverse outcomes after cardiac surgery. The use of factor eight inhibiting bypass activity (FEIBA) in managing bleeding after repair of acute Stanford type A aortic dissection (ATAAD) has not previously been evaluated. We report our experience in utilizing FEIBA in ATAAD repair. Study Design and Methods: A retrospective review was undertaken of all consecutive patients who underwent repair of ATAAD between July 2014 and December 2019. Patients were divided into two groups, dependent upon whether or not they received FEIBA intraoperatively: "FEIBA" (n = 112) versus "no FEIBA" (n = 119). From this, 53 propensity‐matched pairs of patients were analyzed with respect to transfusion requirements and short‐term clinical outcomes. Results: Thirty‐day mortality for the entire cohort was 11.7% (27 deaths), not significantly different between patient groups. Those patients who received FEIBA demonstrated reduced transfusion requirements for all types of blood products in the first 48 h after surgery as compared with the "no FEIBA" cases, including red blood cells, platelets, plasma, and cryoprecipitate (p <.0001). There was no significant difference in major postoperative morbidity between the two groups. The FEIBA cohort did not demonstrate an increased incidence of thrombotic complications (stroke, deep venous thrombosis, pulmonary thromboembolism). Discussion: When used as rescue therapy for refractory bleeding following repair of ATAAD, FEIBA appears to be effective in decreasing postoperative transfusion requirements whilst not negatively impacting clinical outcomes. These findings should prompt further investigation and validation via larger, multi‐center, randomized trials. [ABSTRACT FROM AUTHOR]

Published
2022
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49. Type A Acute Aortic Dissection Presenting With Cerebrovascular Accident at Advanced Age.

Author

Angleitner, Philipp, Brinster, Derek R., Gleason, Thomas G., Harris, Kevin M., Evangelista, Arturo, Bekeredjian, Raffi, Montgomery, Daniel G., Sandhu, Harleen K., Arnaoutakis, George J., Di Eusanio, Marco, Trimarchi, Santi, Nienaber, Christoph A., Isselbacher, Eric M., Eagle, Kim A., and Ehrlich, Marek P.

Abstract

Our aim was to analyze outcomes of patients aged 70 years or above presenting with type A acute aortic dissection (TAAAD) and cerebrovascular accident (CVA). A retrospective analysis of the International Registry of Acute Aortic Dissection (IRAD) was conducted. Patients aged 70 years or above (n = 1449) were stratified according to presence or absence of CVA before surgery (CVA: n = 110, 7.6%). In-hospital outcomes and mortality up to 5 years were analyzed. Additionally, in-hospital outcomes of patients who received medical management were described. No patient presenting with CVA over the age of 87 years underwent surgery. The rates of in-hospital mortality and post-operative CVA were significantly higher in patients presenting with CVA (in-hospital mortality: 32.7% vs 21.7%, P = 0.008; post-operative CVA: 23.4% vs 8.3%, P < 0.001). Presence of CVA was independently associated with significantly increased in-hospital mortality (odds ratio 2.99, 95% confidence interval 1.35 - 6.60, P = 0.007). In survivors of the hospital stay, presenting CVA had no independent influence on mortality up to 5 years (hazard ratio 1.52, 95% confidence interval 0.99 - 2.31, P = 0.54). In medically managed patients, exceedingly high rates of in-hospital mortality (71.4%) and CVA (90.9%) were noted. Patients presenting with TAAAD and CVA at ≥ 70 years of age are at significantly increased risk of in-hospital mortality, although long-term mortality is not affected in hospital survivors. Medical management is associated with poor outcomes. We believe that surgical management should be offered after critical assessment of comorbidities. [ABSTRACT FROM AUTHOR]

Published
2022
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