High Survival Rate

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Survival high after successful surgery for type A aortic dissection

Ann Arbor, MI – Survival rates three years after surgery for type A aortic dissection are “excellent,” as long as patients survive to hospital discharge, a new study suggests [1]. The findings emphasize that in the modern-day surgical era, patients who receive surgery and come through it successfully have a good chance of surviving long term, Dr Thomas T Tsai (University of Michigan Cardiovascular Center, Ann Arbor) and colleagues write in a surgery supplement to Circulation July 4, 2006.

“This should reenergize us to try to diagnose and treat these patients as quickly as possible,” Tsai commented to heartwire. “You have a lifesaving treatment that is effective in the short and long term, so it should really light a fire under us to push forward and get better at diagnosing this earlier, implementing treatment more quickly, and educating the lay public about the importance of coming to the hospital when they have symptoms.”

According to the Tsai et al, this new analysis from the International Registry of Aortic Dissection (IRAD) database examined 303 patients who survived to hospital discharge after being treated at 21 medical centers in 11 countries between 1996 and 2003. As such, it represents a much more contemporary picture of aortic dissection; previous observational studies have had to collect data over much longer periods of time and as such do not as closely reflect current techniques and management.

“What’s new is that, given the contemporary care that we give patients internationally, if a patient comes to a hospital and is treated for their dissection, as long as they survive to hospital discharge, they can do quite well,” Tsai said. “In our study, more than 90% of patients were alive at three years, and given the catastrophic nature of the disease, that’s encouraging.”

As Tsai et al report, 90.1% of the cohort was treated surgically, while 9.9% were managed medically, either because they refused surgery or had major comorbidities. After three years of follow-up, 90.5% of the surgically treated patients had survived, compared to 63.7% of medically treated patients. Patients who died were more likely to have had preexisting atherosclerosis and to have undergone prior cardiac surgery. “If people have preexisting comorbidities, even if you fix the underlying problem, they still have underlying atherosclerosis. They are still more likely than patients without CAD to die of a heart attack. It’s really saying that while the surgical site may be well protected, you can’t revert their other comorbidities.”

Tsai emphasized that surgery is the standard of care for aortic-dissection patients; what was surprising about the IRAD analysis is that even if patients did not undergo surgery, as long as they were strong enough to survive hospital discharge, the chances of surviving three years “were not so bad,” Tsai said. This implies that nonsurgical aortic-dissection survivors “deserve and probably benefit from ongoing medical therapy,” the authors conclude.

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1 gary watson January 26, 2015 at 11:20 pm

I had a Type A dissected aorta March 7 2014. I was flow from Madison Indiana to Louisville Kentucky’s Jewish Hospital at the Rudd Heart & Lung Center. My surgery took approx. 11 hours from start to finish. I survived and was released 7 days later. I had an excellent SURGEON- Dr. Mark Slaughter & his team saved me from certain death. Anyway I am making the slow recovery from this ordeal. I’ve gained much of my strength back, but I also have osteo arthritis in both knees-it’ chronic and I will require a double knee replacement. I had 3 herniated disc’cs in my lower back prior to my heart condition. I have had NO treatment for this. Additionally I have Stage 1 lung disease, but have stopped smoking in March and have not had not smoked since. I have been put on SSD and no longer work. My place of employment was full of flour dust which I was exposed to for 20 years. Anyway I take my medications everyday- I do my cardio exercises at out local YMCA. I just started some upper body building but am limited to 20 lbs. I do pedal about 3 miles per trip and sometimes 4 miles per trip on a stationary bike- It must all be low impact on my knees. I did put on 20 lbs. from Aug thru Jan, an my cardiologist instructed me to start working on getting it off. Our director at our YMCA has been very helpful in guiding me on proper nutrition and the importance of eating a balance diet and NOT trying to starve myself. But with God’s Grace and continued Blessings I hope to live many years. My dissection struck me at the age of 57 years! I’m quickly closing in on my 1 year anniversary and hope to celebrate many more. God Bless you all.

2 Marlon June 6, 2015 at 6:23 pm

I had an aortic dissection at age 46. Before this I had four lower back surgeries. Last one was a fusion with instrumentation. I just turned 48 last week and have a very good quality of life. Unfortunately I still have a dissection on the other side of my heart. So far God has blessed me and by taking my meds and listening to my body (and wife) I am doing good and enjoying everyday given to me. I was by myself when pain hit and drove myself to hospital then passed out in front of E.R. Woke up a day and a half later in another hospital and didn’t remember a thing. Give thanks to God everyday. Very hard not to dwell on when will it happen again tho.!

3 Bruno DeBerdt June 17, 2015 at 12:46 am

Suffered an assending aortic dissection July 10th, 2014. Had 8 inches of my aortic artery repaired along with an aortic valve replacement. Surgery took 9 hours, followed by a 2nd surgery 12 days later to remove fluid build up around the heart. I was extremely lucky as my heart stopped 2 hours after my attack. Needless to say I owe my life to the ER department and surgeon Dr. Sortero. Started my rechap 30 days after my release from the hospital (22 days) and continue my maintenance program at the hospital twice weekly. I am back to a normal lifestyle and aside from my medication and weekly INR monitoring am living a normal and great life.

4 Reg Butts July 6, 2015 at 1:00 pm

I am 81 years old, and three years ago in January I had a quad bi-pass, then two months laster i was rushed to surgency for a aortic disection, and a week later, another surgency to remove the infection in my lungs. I have 27 % used of my heart. How long of a life can I expect?

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