The DeBakey classification divides Stanford acute type A aortic dissection (ATAAD) into DeBakey type I (D1) and type II (D2) according to the extent of acute aortic dissection (AAD). Patients with D1- acute aortic dissection had a higher risk of in-hospital mortality than those with D2- acute aortic dissection, suggests a recent study published in the Journal of Cardiothoracic Surgery.
Chun-Yu Lin et al from the Department of Medicine, College of Medicine, Chang Gung University, Taoyuan City, Taiwan conducted a retrospective study which aimed to compare the early and late outcomes of D1-AAD and D2-AAD through a propensity score-matched analysis.
The authors included a total of 599 consecutive patients, all of whom underwent acute type A aortic dissection repair at the institution and were dichotomized into D1 (n = 543; 90.7%) and D2 (n = 56; 9.3%) groups.
Propensity scoring was performed with a 1:1 ratio, resulting in a matched cohort of 56 patients per group. The clinical features, postoperative complications, 5-year cumulative survival and freedom from reoperation rates were compared.
The following findings were highlighted-
In the overall cohort, the D1 group had a lower rate of preoperative shock and more aortic arch replacement with longer cardiopulmonary bypass time.
The D1 group had a higher in-hospital mortality rate than the D2 group in overall (15.8% vs 5.4%; P = 0.036) and matched cohorts (19.6% vs 5.4%; P = 0.022).
For patients that survived to discharge, the D1 and D2 groups demonstrated similar 5-year survival rates in overall (77.0% vs 85.2%; P = 0.378) and matched cohorts (79.1% vs 85.2%; P = 0.425).
The 5-year freedom from reoperation rates for D1 and D2 groups were 80.0% and 97.1% in overall cohort (P = 0.011), and 93.6% and 97.1% in matched cohort (P = 0.474), respectively.
Hence, the researchers concluded that "patients with D1 acute aortic dissection had a higher risk of in-hospital mortality than those with D2- acute aortic dissection."
However, for patients who survived to discharge, the 5-year survival rates were comparable between both groups, they further added.
For further reference log into:
Lin, CY., Tung, TH., Wu, MY. et al. Surgical outcomes of DeBakey type I and type II acute aortic dissection: a propensity score-matched analysis in 599 patients. J Cardiothorac Surg 16, 208 (2021). https://doi.org/10.1186/s13019-021-01594-9