Importance of Blood Pressure Control After Repair of Acute Type A Aortic Dissection: 25-Year Follow-Up in 252 Patients

Abstract

The purpose of this study was to evaluate factors that impact outcome following repair of type A aortic dissection. Over 25years (1984-2009), 252 patients underwent repair of acute type A dissection. Mean follow-up for reoperation or death was 6.9±5.9years. Operative mortality was 16% (41 of 252). Multivariate analysis identified one risk factor for operative death: presentation malperfusion (P=003). For operative survivors, 5-, 10-, and 20-year survival was 78%±3%, 59%±4%, and 24%±6%, respectively. Late death occurred earlier in patients with previous stroke (P=02) and chronic renal insufficiency (P=007). Risk factors for late reoperation included male sex (P=006), Marfan syndrome (P <120mmHg had improved freedom from reoperation (92±5%) compared with those with SBP 120 mm Hg to 140mmHg (74%±7%) or >140mmHg (49%±14%, P