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This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Roberto Flocco Luca Weltert Antonio M. Calafiore Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Centofanti, P. Articles by Calafiore, A. M. Search for Related Content PubMed Articles by Centofanti, P. Articles by Calafiore, A. M. Related Collections Great vessels Related Article

Ann Thorac Surg 2007;84:1070-1071
© 2007 The Society of Thoracic Surgeons

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Correspondence

Reply

University of Turin, Divisione di Cardiochirurgia, Turin, C.so Bramante 88, Italy

(Email: paolocentofanti{at}tiscali.it).

To the Editor:

We strongly appreciate the considerations that Dr Lima-Cañadas and colleagues [1] made to our article on the risk model to predict surgical mortality in acute type A aortic dissection [2]. Their letter to the editor shows a strong correlation between the model’s predicted mortality and the observed mortality in the Spanish Dataset. Considering that our score uses only preoperative independent predictors of 30-day mortality, this result is pretty good. Our experience confirms that main determinants of surgical mortality in these patients are preoperative complications and comorbidities.

We believe that the aortic dissection mortality score can provide an accurate and simple prediction of mortality risk and may help the physician in choosing the most appropriate strategy.

The aim of this model is directed to:

(1) help the surgeons to choose whether or not to proceed with surgical correction in patients presenting extreme clinical conditions.

(2) assist surgeons in advising patients and their families about the realistic chances of the operation.

(3) give the surgeons a tool to evaluate their survival rate and the overall performance compared with a standard performance index, as we learned to do with Euroscore in everyday practice.

We actually believe that emergency surgery is "the" elective option for most type A aortic dissections. Anyhow we hope that, if this model will be validated by the scientific community, more experience will be made with optimized medical management in high-risk groups of patients giving new evidence for a medical option for these unlucky patients.

	References

Top References

 

1. Lima-Cañadas PP, López-Álmodovar LF, Vallejo JL, Diaz de Tuesta I. Can the risk associated with surgery in type A aortic dissection be predicted accurately?(letter) Ann Thorac Surg 2007;84:1070.[Free Full Text]
2. Centofanti P, Flocco R, Ceresa F, et al. Is surgery always mandatory for type A aortic dissection? Ann Thorac Surg 2006;82:1658-1663discussion 1664.[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Roberto Flocco Luca Weltert Antonio M. Calafiore Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Centofanti, P. Articles by Calafiore, A. M. Search for Related Content PubMed Articles by Centofanti, P. Articles by Calafiore, A. M. Related Collections Great vessels Related Article