0000000000388020

AUTHOR

Tobias Krüger

Lessons Learned from the German Registry for Acute Aortic Dissection Type A (GERAADA) and Expectations for the Future

The German Registry for Acute Aortic Dissection type A (GERAADA) is a prospective observational clinical multicenter registry that was launched in 2006. With more than 2,500 patients included from over 50 recruiting centers it is—to our knowledge—the most representative register for acute aortic dissection type A (AADA) currently available. We examined mortality and post-operative events as well as the influence of various pre- and intraoperative factors on these endpoints. Among patients registered, 30-day mortality is 15.9 %. 13.4 % of patients experienced postoperatively a new neurological deficit and a total of 10.5 % of patients suffered from permanent neurological impairment 30 days a…

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Early outcomes of patients with Marfan syndrome and acute aortic type A dissection.

Acute aortic Stanford type A dissection remains a frequent and life-limiting event for patients with Marfan syndrome. Outcome results in this high-risk group are limited.The German Registry for Acute Aortic Dissection Type A collected the data of 56 centers between July 2006 and June 2015. Of 3385 patients undergoing operations for acute aortic Stanford type A dissection, 117 (3.5%) were diagnosed with Marfan syndrome. We performed a propensity score match comparing patients with Marfan syndrome with patients without Marfan syndrome in a 1:2 fashion.Patients with Marfan syndrome were significantly younger (42.9 vs 62.2 years; P  .001), predominantly male (76.9% vs 62.9%; P = .002), and less…

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Intraoperative neuroprotective drugs without beneficial effects? Results of the German Registry for Acute Aortic Dissection Type A (GERAADA).

OBJECTIVES: Cerebral protection during acute aortic dissection Type A (AADA) surgery may be affected by perfusion strategies and ischaemic protective drugs. METHODS: We analysed the impact of intraoperative barbiturate, steroid and mannitol use and adjunctive cerebral perfusion (CP), on 30-day mortality and new postoperative mortality-corrected permanent neurological dysfunction (PNDmc) in the German Registry for Acute Aortic Dissection Type A. RESULTS: Two thousand one hundred and thirty-seven AADA patients were registered over a 4-year period. The overall 30-day mortality was 16.9%, and the overall rate of PNDmc was 10.0%. A total of 48% of patients received no neuroprotective drugs (cont…

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Acute aortic dissection type A

Abstract Background Acute aortic dissection type A (AADA) is a life-threatening vascular emergency. Clinical presentation ranges from pain related to the acute event, collapse due to aortic rupture or pericardial tamponade, or manifestations of organ or limb ischaemia. The purpose of this review was to clarify important clinical issues of AADA management, with a focus on diagnostic and therapeutic challenges. Methods Based on a MEDLINE search the latest literature on this topic was reviewed. Results from the German Registry for Acute Aortic Dissection Type A (GERAADA) are also described. Results Currently, the perioperative mortality rate of AADA is below 20 per cent, the rate of definitive…

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