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European Registry of Type A Aortic Dissection

Completed
Conditions
Type A Aortic Dissection
Interventions
Procedure: Surgery on the ascending aorta with or without repair of the aortic root and/or aortic arch
Registration Number
NCT04831073
Lead Sponsor
Helsinki University Central Hospital
Brief Summary

Acute Stanford type A aortic dissection (TAAD) is a life-threatening condition. Surgery is usually performed as a salvage procedure and is associated with significant postoperative early mortality and morbidity. Understanding the patient's conditions and treatment strategies which are associated with these adverse events is essential for an appropriate management of acute TAAD.

Detailed Description

Twenty centers from eight European centers of cardiac surgery have collaborated to create a multicentre observational registry (ERTAAD), which will enroll consecutive patients who underwent surgery for acute TAAD from January 2005 to March 2021. The investigators will compare patient's comorbidities, condition at referral, surgical strategies and perioperative treatments in patients with and without early and late adverse events. The primary clinical outcome will be in-hospital mortality, late mortality and reoperations on the aorta. Secondary outcomes will be stroke, acute kidney injury, surgical site infection, reoperation for bleeding, transfusion of blood products and length of stay in the intensive care unit.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
3902
Inclusion Criteria
  • Type A aortic dissection or intramural hematoma involving the aortic root/ascending aorta;
  • Patients aged > 18 years:
  • Symptoms started within 7 days from surgery;
  • Primary surgical repair of acute type A aortic dissection;
  • Any other major cardiac surgical procedure concomitant with surgery for type A aortic dissection.
Exclusion Criteria
  • Patients aged < 18 years;
  • Onset of symptoms > 7 days from surgery;
  • Prior procedure for type A aortic dissection;
  • Retrograde type A aortic dissection (with primary tear located in the descending aorta);
  • Concomitant endocarditis;
  • Type A aortic dissection secondary to blunt or penetrating chest trauma.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Acute type A aortic dissectionSurgery on the ascending aorta with or without repair of the aortic root and/or aortic archPatients who underwent surgery for acute type A aortic dissection
Primary Outcome Measures
NameTimeMethod
Mortality rateDuring the index hospital stay until last follow-up control

All-cause mortality

Cumulative incidence of reoperation on the aortaDuring the index hospital stay until last follow-up control

Any surgical and endovascular procedure on any segment of the aorta for aortic dissection or its related complication

Secondary Outcome Measures
NameTimeMethod
Incidence of strokeFrom date of procedure until the date of hospital discharge, assessed up to 3 months

change in the level of consciousness, hemiplegia, hemiparesis, numbness, or sensory loss affecting one side of the body, dysphasia or aphasia, hemianopia, amaurosis fugax, or other neurological signs or symptoms consistent with stroke duration of a focal or global neurological deficit ≥ 24 h; OR \<24 h if available neuroimaging documents a new brain hemorrhage or infarct; OR the neurological deficit results in death.

Incidence of reoperation for bleedingFrom date of procedure until the date of hospital discharge, assessed up to 3 months

Chest reopening for excessive bleeding.

Incidence of acute kidney injuryFrom date of procedure until the date of hospital discharge, assessed up to 3 months

It will be defined according to postoperative change in serum creatinine levels and its severity will be stratified according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria

Incidence and amount of blood transfusionFrom date of procedure until the date of hospital discharge, assessed up to 3 months

Transfusions of red blood cells

Length of stay in the intensive care unitFrom date of procedure until the date of hospital discharge, assessed up to 3 months

Duration of stay in the intensive care unit

Incidence of paraplegia/paraparesisFrom date of procedure until the date of hospital discharge, assessed up to 3 months

Bilateral weakness and/or multimodality sensory disturbance below the level of the ischemic spinal lesion.

Incidence of surgical site infectionFrom date of procedure until the date of hospital discharge, assessed up to 3 months

Proven infection involving deep sternal wound tissues and/or mediastinum.

Incidence of global brain ischemiaFrom date of procedure until the date of hospital discharge, assessed up to 3 months

Diffuse hypoxic damage as diagnosed at brain imaging and electroencephalography.

Trial Locations

Locations (20)

Saint-Luc's Hospital

🇧🇪

Brussels, Belgium

Ziekenhuis Oost-Limburg

🇧🇪

Genk, Belgium

University Hospitals Leuven

🇧🇪

Leuven, Belgium

Helsinki University Hospital

🇫🇮

Helsinki, Finland

University of Udine

🇮🇹

Udine, Italy

University of Verona Medical School

🇮🇹

Verona, Italy

Liverpool Heart and Chest Hospital

🇬🇧

Liverpool, United Kingdom

AZ St-Jan

🇧🇪

Brugge, Belgium

University Hospital Antwerp

🇧🇪

Edegem, Belgium

Institute of Clinical and Experimental Medicine

🇨🇿

Prague, Czechia

Henri Mondor University Hospital

🇫🇷

Créteil, Paris, France

Münster University Hospital

🇩🇪

Münster, Germany

University Heart & Vascular Centre Hamburg

🇩🇪

Hamburg, Germany

Leipzig Heart Center

🇩🇪

Leipzig, Germany

University Hospital Jean Minjoz

🇫🇷

Besançon, France

University of Torino

🇮🇹

Torino, Italy

Hospital Clínic de Barcelona

🇪🇸

Barcelona, Spain

University Hospitals of Leicester

🇬🇧

Leicester, United Kingdom

Southampton University Hospital

🇬🇧

Southampton, United Kingdom

Northern General Hospital

🇬🇧

Sheffield, United Kingdom

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