OBJECTIVES: The optimal surgical strategy for acute @entity1580 (ATAAD) is still controversial because of the inconsistent or even conflicting results of proximal aortic repair (PR) versus extensive aortic repair (ER) on early and late prognostic outcomes. This meta-analysis pooled data from all available studies of PR versus ER to get a summarized conclusion. METHODS: Studies were identified by searching the Medline, EMBASE and Cochrane databases. Early and late prognostic outcomes of interest were evaluated with meta-analysis. Fixed- or random-effect models were used according to the significance of heterogeneity. Robustness of pooled estimates and the source of heterogeneity were assessed via sensitivity analyses and meta-regression, respectively. Publication bias was evaluated by the funnel plot and Egger's test. RESULTS: Nine studies with a total of 1872 @entity1 were included for the meta-analysis. Pooled results indicated that, when compared with the ER procedure, PR was associated with lower early mortality [risk ratio (RR) = 0.69, 95% confidence interval (CI) 0.54-0.90, P = 0.005] but higher incidence of postoperative aortic events including reoperation of the distal aorta (RR = 3.14, 95% CI 1.74-5.67, P < 0.001). PR and ER demonstrated analogous prognosis on long-term mortality (HR = 1.02, 95% CI 0.51-2.06, P = 0.96) and the incidences of early @entity177 (RR = 0.75, 95% CI 0.49-1.14, P = 0.17) and @entity64 (RR = 0.73, 95% CI 0.30-1.78, P = 0.50). All the pooled results were robust to sensitivity analysis. Heterogeneity was insignificant except for the meta-analysis of late mortality. CONCLUSIONS: Performing a less aggressive initial surgical procedure of PR in ATAAD @entity1 would have lower early mortality but elevated incidence rates of late aortic reintervention, when compared with ER. Other prognostic results of the two surgical strategies including long-term mortality were similar for both.

Proximal aortic repair versus extensive aortic repair in the treatment of acute XXXX : a meta-analysis.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity177 :: ('MESH:D051437', 'Disease') :: ['postoperative renal failure'] @entity64 :: ('MESH:D020521', 'Disease') :: ['stroke'] @entity1580 :: ('MESH:C562834', 'Disease') :: ['type A aortic dissection']
@entity1580 :: (MESH:C562834,Disease) :: ['type A aortic dissection']
