Original Minneapolis Heart Institute Foundation® (MHIF) research was published online in the Journal of the American Medical Association - Cardiology revealing the contemporary mortality for acute Type A aortic dissection (TAAAD). An aortic dissection is caused by a tear in the inner layer of the aorta (the body’s main artery supplying blood to the body) and is associated with a high mortality rate in the first 24-48 hours. The stated mortality rate has been frequently quoted to be 1% per hour based on data before surgical treatment became routine. Over the last 50 years there have been countless improvements in diagnostic testing as well as in medical and surgical treatment. This new research describes the current early mortality, which while less than previously described, is still significant. Kevin Harris, MD, cardiologist and researcher at MHIF is the lead author on the publication.
The conclusion of the study showed that 48-hour mortality is 4.4 percent for patients in the surgical group compared to 23.7 percent in patients who received medical management. The new research reflects a study of more than 5,600 patients in the International Registry of Acute Aortic Dissection who received care between 1996-2018. This study highlights the difference in outcomes between patients treated surgically compared to those who received non-surgical, medical management (where the patients were judged high risk for surgery or patients elected against surgery). Patients were grouped according to the mode of their intended treatment. In the surgical group, 51 patients (1%) died before the operation emphasizing the importance of timely surgical intervention in this patient population.
The primary goal of care for these patients in the acute setting is survival – preventing death – and it requires rapid diagnosis and surgical treatment. These data serve as a sobering reminder that an acute aortic dissection merits efforts to improve recognition, as well as rapid transfer and surgical treatment protocols.
This is another example of MHIF’s expertise in advancing aortic dissection research. Last year, original MHIF research was published showcasing the benefits of integrated care between specialties to expedite the diagnosis and transfer, standardize pharmacotherapy and pre- and intraoperative imaging protocols, expedite operating room mobilization and determine the optimal surgical approach for patients with aortic dissection. Learn more about that research publish in the Journal of Vascular Surgery.