Trends in management of the acute type A aortic dissection over 15 years: Insights from a large retrospective observational study

Background Acute type A aortic dissection is one of the most hazardous acute vascular pathology. Purpose To investigate trends in the management of acute type A aortic dissections on the last 15 years. Methods All consecutive patients who were operated on for an acute type A aortic dissection at the CHU of Toulouse, France, between 2005 and 2019 were retrospectively included. We compared demographics, diagnostic methods and surgical techniques between 3 periods: 2005–2009, 2010–2014 and 2015–2019 ( Table 1 ). Results A total of 507 patients were included, mean age was 63 ± 12 years, 354 (70%) were male and 299 (59%) had hypertension. Demographics were similar across periods. About clinical presentation, the proportion of patients admitted to the operating room with cardiac arrest has increased between the 3 periods (12% vs 5% vs7%; P  Fig. 1 ). Conclusion Over a 15-years period, the demographics of patients operated on for type A aortic dissection has not significantly changed. However, there is a trend towards the management of patients in a more life-threatening condition. Most of the shifts relate to surgical techniques, with a more proactive approach to the treatment of associated aortic regurgitation.