Summary
This observational study reports a decade of experience with centralised acute type A aortic dissection (ATAAD) repair at a single institution using a dedicated multidisciplinary team model. Implementation of a streamlined transfer protocol (RACE-AD) in 2013 nearly doubled institutional case volume whilst maintaining mortality below 10%, suggesting that regional centralisation of emergency aortic surgery to high-volume centres can improve population outcomes without compromising individual surgeon expertise.
UK applicability
The findings support arguments for centralisation of emergency aortic services, which aligns with NHS policy encouraging specialist vascular centres. However, the study is single-centre and US-based; UK applicability depends on comparable infrastructure, staffing, and patient transfer capabilities within the NHS emergency network.
Key measures
30-day/in-hospital mortality rate; institutional ATAAD repair volume (cases per year); individual surgeon ATAAD repair volume; compliance with 5 cases-per-year high-volume threshold
Outcomes reported
The study reported 30-day/in-hospital mortality rates and institutional case volume trends over a 10-year period following implementation of a dedicated acute aortic dissection team and streamlined transfer protocol. Surgical caseload per individual surgeon and compliance with high-volume thresholds were also tracked.
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