Current Surgical Management of Acute Type A Aortic Dissection in China: A Multicenter Registry Study

BACKGROUND: Many countries and regions have established multicenter registration studies to improve the outcomes of acute type A aortic dissection (ATAAD). OBJECTIVES: The aims of this study were to report actual preoperative management, surgery type, and early outcomes of surgical treatment for ATAAD in China. METHODS: This cohort study uses data from the China Registry of Type A Aortic Dissection, a national clinical registry to investigate management of patients with Stanford type A aortic dissection. The data, including surgical management and outcomes of patients with ATAAD, were analyzed from January 2018 to December 2021. RESULTS: A total of 1,058 patients with ATAAD were enrolled in this study between January 2018 and December 2021. The mean age of all patients was 51.6 ±11.7 years. The median interval from onset to hospital was 10.65 hours (IQR: 6–24 hours), and the median interval from entering the emergency room to starting operation was 13 hours (IQR: 4.08–28.7 hours). Total arch repair was performed in 938 patients (88.7%), and frozen elephant trunk repair was performed in 800 patients (75.6%). The incidence of early mortality was 7.6%. CONCLUSIONS: The population of patients with ATAAD in China experienced a longer interval from onset to arrival at the hospital, received more extensive aortic arch repair, and showed a relatively lower early mortality. These findings suggest that there may be a huge survivor bias in patients with ATAAD in China, more efforts should be made to promote prehospital emergency care and preoperative management of Chinese ATAAD patients. (A multicenter registration study of aortic dissection in China; ChiCTR1800015338).