Analysis of acute type A aortic dissection in Japan registry of aortic dissection (JRAD)

Abstract Background In 2011, the Japanese Registration of Acute Aortic Dissection (JRAD) was started in accordance with the model of the International Registration of Acute Aortic Dissection (IRAD). The aim of this study was to report actual clinical early and midterm outcomes of treatment for acute type A dissection in Japan. Methods Between 2011 and 2016, 1217 patients (67.9 years-old, 584 male, 241 >80 years-old) who had suffered from acute type A dissection within 14 days after the onset of symptoms were enrolled. Results Among 75% patients managed surgically 68% underwent surgery with cardiopulmonary bypass. Surgery was not indicated in 25% patients. Overall, 12% died in the hospital: 10.8% after surgical treatment and 16.6% in patients medically treated. The multivariable analysis of in-hospital mortality revealed that patients older than 80 years old [odds ratio 2.37, P Conclusions JRAD data revealed the actual clinical setting for the treatment of acute type A dissection in Japan. Early surgical results were favorable with a low in-hospital morality rate, and midterm outcomes in selected medically treated patients were equivalent. Preoperative severe conditions, including shock, need for preoperative cardiopulmonary resuscitation, and disturbance of consciousness, as well as advanced age, were risk factors for in-hospital mortality even though referral interval was quite fast.