BACKGROUND: Data on outcomes of surgery for chronic Stanford type A aortic dissection are limited. We investigated the primary surgery and long-term results in @entity1 with chronic dissection of the native ascending aorta. METHODS: Between 1993 and 2013, among 696 @entity1 (median age, 61 years [first quartile, 50; third quartile 73 years]; 64% males) who underwent surgery for type A dissection, 67 (10%) had chronic dissection by traditional criteria (>14 days). Median follow-up was 4.1 years (first quartile, 1.9; third quartile, 7.3 years; 3,105 @entity1 -years). RESULTS: @entity1 with chronic dissection more frequently had undergone previous cardiac surgery (37% versus 9%; p < 0.001) and more frequently had bicuspid @entity886 (19% versus 7%; p < 0.001) and larger ascending aortic diameter (6.0 cm [first quartile 5.2; third quartile 7.2 cm] versus 4.9 cm [first quartile, 4.5; third quartile, 5.7 cm]; p < 0.001). @entity1580 extended beyond the aortic arch less frequently in chronic dissection @entity1 (27% versus 70%; p < 0.001). Moderate to severe @entity337 rate was higher in chronic group (65% versus 36%; p < 0.001); they required aortic root replacement more frequently (42% versus 18%; p  <  0.001) and had lower in-hospital mortality (4.5% versus 13.2%; p  = 0.062). Resection of all dissected aortic tissue was achieved in 73% chronic and 30% acute dissection @entity1 . Overall survival was better in the chronic group with 80%    5% versus 68%    2% at 5 years and 64%    13% versus 49%    3% at 10 years (log rank p  =  0.021). CONCLUSIONS: @entity1 with chronic and acute type A dissection differ substantially in presentation, management, and outcome. Replacement of all dissected aortic tissue can be performed safely in the majority of @entity1 with chronic type A dissection.

Outcomes of Surgery for Chronic XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient'] @entity886 :: ('MESH:C563178', 'Disease') :: ['aortic valve syndrome'] @entity1580 :: ('MESH:C562834', 'Disease') :: ['Aortic dissection'] @entity337 :: ('MESH:D001022', 'Disease') :: ['aortic insufficiency']
@entity1580 :: (MESH:C562834,Disease) :: ['Type A Aortic Dissection']
