European registry of type A aortic dissection (ERTAAD) - rationale, design and definition criteria

Fausto Biancari, Giovanni Mariscalco, Hakeem Yusuff, Geoffrey Tsang, Suvitesh Luthra, Francesco Onorati, Alessandra Francica, Cecilia Rossetti, Andrea Perrotti, Sidney Chocron, Antonio Fiore, Thierry Folliguet, Matteo Pettinari, Angelo M Dell'Aquila, Till Demal, Lenard Conradi, Christian Detter, Marek Pol, Peter Ivak, Filip Schlosser, Stefano Forlani, Govind Chetty, Amer Harky, Manoj Kuduvalli, Mark Field, Igor Vendramin, Ugolino Livi, Mauro Rinaldi, Luisa Ferrante, Christian Etz, Thilo Noack, Stefano Mastrobuoni, Laurent De Kerchove, Mikko Jormalainen, Steven Laga, Bart Meuris, Marc Schepens, Zein El Dean, Antti Vento, Peter Raivio, Michael Borger, Tatu Juvonen, Fausto Biancari, Giovanni Mariscalco, Hakeem Yusuff, Geoffrey Tsang, Suvitesh Luthra, Francesco Onorati, Alessandra Francica, Cecilia Rossetti, Andrea Perrotti, Sidney Chocron, Antonio Fiore, Thierry Folliguet, Matteo Pettinari, Angelo M Dell'Aquila, Till Demal, Lenard Conradi, Christian Detter, Marek Pol, Peter Ivak, Filip Schlosser, Stefano Forlani, Govind Chetty, Amer Harky, Manoj Kuduvalli, Mark Field, Igor Vendramin, Ugolino Livi, Mauro Rinaldi, Luisa Ferrante, Christian Etz, Thilo Noack, Stefano Mastrobuoni, Laurent De Kerchove, Mikko Jormalainen, Steven Laga, Bart Meuris, Marc Schepens, Zein El Dean, Antti Vento, Peter Raivio, Michael Borger, Tatu Juvonen

Abstract

Background: Acute Stanford type A aortic dissection (TAAD) is a life-threatening condition. Surgery is usually performed as a salvage procedure and is associated with significant postoperative early mortality and morbidity. Understanding the patient's conditions and treatment strategies which are associated with these adverse events is essential for an appropriate management of acute TAAD.

Methods: Nineteen centers of cardiac surgery from seven European countries have collaborated to create a multicentre observational registry (ERTAAD), which will enroll consecutive patients who underwent surgery for acute TAAD from January 2005 to March 2021. Analysis of the impact of patient's comorbidities, conditions at referral, surgical strategies and perioperative treatment on the early and late adverse events will be performed. The investigators have developed a classification of the urgency of the procedure based on the severity of preoperative hemodynamic conditions and malperfusion secondary to acute TAAD. The primary clinical outcomes will be in-hospital mortality, late mortality and reoperations on the aorta. Secondary outcomes will be stroke, acute kidney injury, surgical site infection, reoperation for bleeding, blood transfusion and length of stay in the intensive care unit.

Discussion: The analysis of this multicentre registry will allow conclusive results on the prognostic importance of critical preoperative conditions and the value of different treatment strategies to reduce the risk of early adverse events after surgery for acute TAAD. This registry is expected to provide insights into the long-term durability of different strategies of surgical repair for TAAD.

Trial registration: ClinicalTrials.gov Identifier: NCT04831073 .

Keywords: Aortic arch; Aortic dissection; Ascending aorta; Emergency; Stanford type A.

Conflict of interest statement

The authors have no competing or financial interest in the information contained in the manuscript.

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