Few aortic dissection survivors receive long-term imaging surveillance

(HealthDay)—Only one in seven people who survive acute type A aortic dissection (ATAAD) receive recommended surveillance imaging, according to a study published in the Nov. 9 issue of the Journal of the American College of Cardiology.

Kevin R. An, M.D., from the University of Toronto, and colleagues sought to define the real-world frequency of postoperative imaging and characterize long-term outcomes of ATAAD. Analysis included 888 patients who survived urgent ATAAD repair between April 1, 2005, and March 31, 2018.

The researchers found that over a median follow-up of 5.2 years, 14 percent of patients received guideline-directed imaging surveillance (GDIS) throughout follow-up. At one year, the mortality rate was 4 percent, compared to 14 percent at five years and 29 percent at 10 years. At one year, the incidence of aortic reintervention was 3 percent, compared to 9 percent at five years and 17 percent at 10 years. The majority of reinterventions were urgent (68 percent), and they carried a 30-day mortality rate of 9 percent. Greater adherence to GDIS was associated with mortality (hazard ratio, 1.08) and reintervention (hazard ratio, 1.04).

"Adherence to GDIS following ATAAD repair is poor, while long-term mortality and reinterventions remain substantial," the authors write.

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