Emerging surgical techniques shown to reduce heart surgery complications

A new study reports that emerging surgical techniques used to perform more extensive surgical repairs of type A dissection is improving long-term outcomes for patients.

The research, published online June 6 in The Annals of Thoracic Surgery, found that surgeons are increasingly adapting their surgical strategies to more aggressively treat aortic dissections.

The mortality rate for this type of procedure is about 19 percent, but new techniques have reduced complications like pneumonia and reoperation.

"Type A aortic dissection requires emergency surgical repair," said Ravi K. Ghanta, MD, the lead author on the study and formerly of the University of Virginia in Charlottesville, now with Baylor College of Medicine in Houston, in a statement. "This study shows that surgeons are adapting their surgical strategies to more aggressively treat aortic dissections, surprisingly, without additional upfront risk. Therefore, patients are benefiting from more extensive repair of aortic dissection, which may lead to improved long-term outcomes."

In Ghanta’s study, researchers reviewed medical records of 884 patients who underwent operations for acute type A aortic dissection from 2003 to 2015. Patients were gathered from all centers in Virginia, making the study more representative of big and small providers in the state.

Results showed that in patients who underwent increasingly complex operations over time, including aortic root surgery and aortic arch repair, complications were greatly reduced, though mortality rate remained stable.

"Surgeons are increasingly comfortable with performing more extensive repairs of the aorta and utilizing new surgical techniques, and they are doing so without increasing risk," Ghanta said. "However, while the operative mortality numbers are lower than historical outcomes, 19 percent is still significant and further improvement is needed."