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Review

Management of Type A Aortic Dissections: A Meta-Analysis of the Literature

^a Department of Surgery and Radiology, Sections of Vascular Surgery, and Interventional Radiology, Section of Cardiothoracic Surgery, Yale University School of Medicine, New Haven, Connecticut
^b Section of Vascular Surgery, Department of Surgery, University Medical Center, Utrecht, the Netherlands

^_* Address correspondence to Dr Muhs, Department of Surgery and Radiology, Yale University School of Medicine, 333 Cedar St, BB-204, New Haven, CT 06510 (Email: bart.muhs{at}yale.edu).

The authors reviewed all published series of type A iatrogenic aortic dissections and performed meta-analyses to investigate the management and outcomes of this complication. The majority of type A iatrogenic aortic dissections occurred during cardiac surgery, but the incidence of iatrogenic aortic dissection was considerably higher during thoracic endovascular aortic repair. Intraoperative diagnosis of iatrogenic aortic dissection was made in 69% of patients, and surgical repair of the dissection was performed in 88%. The overall in-hospital mortality was 38%, and the intraoperative diagnoses (odds ratio 0.35; p = 0.01) and surgical repairs (odds ratio 0.09; p = 0.001) were associated with reduced in-hospital mortality in univariate regression analysis.

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