Operative Strategies and Outcomes in Type A XXXX After the Enactment of a Multidisciplinary Aortic Surgery Team.

@entity1 @entity697 @entity260 @entity177 @entity1580
OBJECTIVE: The purpose of this study was to compare operative strategies and @entity1 outcomes in @entity697 ( @entity697 ) repairs before and after the implementation of a multidisciplinary aortic surgery team. METHODS: Between May 2005 and July 2014, 101 @entity1 underwent @entity697 repair at our institution. A dedicated multidisciplinary aortic surgery team (experienced aortic surgeon, perfusionists, cardiac anesthesiologists, nurses, and radiologists) was formed in 2010. We retrospectively compared @entity697 repair outcomes in @entity1 before (2005-2009, N = 39) and after (2010-2014, N = 62) implementation of our program. Expected operative mortality was calculated using the International Registry of Acute @entity1580 preoperative predictive model. RESULTS: This study demonstrated a significant reduction in operative mortality after implementation of the aortic surgery program (30.8% vs. 9.7%; P = 0.014). There was also an increase in the complexity of surgical technique and perfusion strategies with fewer @entity260 related to respiratory (P < 0.0001) and @entity177 (P = 0.034). Baseline demographics were similar, and there was no statistically significant difference in International Registry of Acute @entity1580 predictive variables between the 2 groups. However, there was a 3.5-fold reduction in the observed-to-expected (O/E) operative mortality ratio. There was a 50% increase in volume with a significant number of @entity1 being admitted directly to our aortic center for @entity697 repair, thus avoiding delay in operation related to transfers from a secondary hospital. CONCLUSIONS: @entity1 outcomes are improved when the surgical treatment of @entity697 is managed by a high-volume multidisciplinary aortic surgery team.
