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Knowledge, attitudes, and practice preferences of Canadian cardiac surgeons toward the management of acute type A aortic dissection  Mark D. Peterson,

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Presentation on theme: "Knowledge, attitudes, and practice preferences of Canadian cardiac surgeons toward the management of acute type A aortic dissection  Mark D. Peterson,"— Presentation transcript:

1 Knowledge, attitudes, and practice preferences of Canadian cardiac surgeons toward the management of acute type A aortic dissection  Mark D. Peterson, MD, PhD, FRCSC, Amine Mazine, MD, MSc, Ismail El-Hamamsy, MD, PhD, FRCSC, Cedric Manlhiot, BSc, Maral Ouzounian, MD, PhD, FRCSC, Roderick G.G. MacArthur, MD, MSc, FRCSC, Jeremy R. Wood, MD, FRCSC, John Bozinovski, MD, MSc, FRCSC, Jehangir Apoo, MD, FRCSC, Michael C. Moon, MD, FRCSC, Munir Boodhwani, MD, MMSc, FRCSC, Ansar Hassan, MD, PhD, FRCSC, Subodh Verma, MD, PhD, FRCSC, Francois Dagenais, MD, FRCSC, Michael W.A. Chu, MD, FRCSC Nancy Poirier, Raymond Cartier, Philippe Demers, Kevin Lachapelle, Éric Dumont, Gopal Bhatnagar, Fuad Moussa, Daniel Bonneau, Scott McClure, Gary Salasidis, Ray Guo, Zlatko Pozeg, John Tsang, Daniel Wong Mark D. Peterson, MD, PhD, FRCSC, Amine Mazine, MD, MSc, Ismail El-Hamamsy, MD, PhD, FRCSC, Cedric Manlhiot, BSc, Maral Ouzounian, MD, PhD, FRCSC, Roderick G.G. MacArthur, MD, MSc, FRCSC, Jeremy R. Wood, MD, FRCSC, John Bozinovski, MD, MSc, FRCSC, Jehangir Apoo, MD, FRCSC, Michael C. Moon, MD, FRCSC, Munir Boodhwani, MD, MMSc, FRCSC, Ansar Hassan, MD, PhD, FRCSC, Subodh Verma, MD, PhD, FRCSC, Francois Dagenais, MD, FRCSC, Michael W.A. Chu, MD, FRCSC Nancy Poirier, Raymond Cartier, Philippe Demers, Kevin Lachapelle, Éric Dumont, Gopal Bhatnagar, Fuad Moussa, Daniel Bonneau, Scott McClure, Gary Salasidis, Ray Guo, Zlatko Pozeg, John Tsang, Daniel Wong  The Journal of Thoracic and Cardiovascular Surgery  Volume 150, Issue 4, Pages e5 (October 2015) DOI: /j.jtcvs Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

2 Figure 1 Cardiac surgeon demographics. A, Years in practice. B, Average number of cases performed per year. C, Proportion of aortic surgery in current practice. D, Average number of type A dissection repairs performed per year. The Journal of Thoracic and Cardiovascular Surgery  , e5DOI: ( /j.jtcvs ) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

3 Figure 2 Contraindications to surgery. A, Age threshold considered as a contraindication to surgery. B, Contraindications to operative management of acute type A aortic dissection. CPR, Cardiopulmonary resuscitation. The Journal of Thoracic and Cardiovascular Surgery  , e5DOI: ( /j.jtcvs ) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

4 Figure 3 Survey results for cannulation preferences. A, Preferred arterial cannulation site. B, Clamping of the aorta during the cooling phase. The Journal of Thoracic and Cardiovascular Surgery  , e5DOI: ( /j.jtcvs ) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

5 Figure 4 Survey results for temperature management and cerebral protection. A, Target lowest nasopharyngeal temperature during DHCA. B, Target lowest nasopharyngeal temperature for surgeons with 5 or less versus more than 5 type A dissection repairs per year. C, Preferred cerebral perfusion strategy. D, Preferred cerebral perfusion strategy for low-volume versus high-volume aortic surgeons. ACP, Antegrade cerebral perfusion; RCP, retrograde cerebral perfusion; TAD, type A dissection. The Journal of Thoracic and Cardiovascular Surgery  , e5DOI: ( /j.jtcvs ) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

6 Figure 5 Survey results for threshold for replacement of the aortic root during type A dissection repair. A, Threshold for replacement of the aortic root during type A dissection repair. B, Threshold for replacement of the aortic root for low-volume versus high-volume aortic surgeons. The Journal of Thoracic and Cardiovascular Surgery  , e5DOI: ( /j.jtcvs ) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

7 Figure E1 Cardiac surgeon demographics. Region of practice.
The Journal of Thoracic and Cardiovascular Surgery  , e5DOI: ( /j.jtcvs ) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

8 Figure E2 Survey results for management of an intimal tear originating in the aortic arch. ET, Elephant trunk; RAA, replacement of the ascending aorta; TAR, total arch replacement. The Journal of Thoracic and Cardiovascular Surgery  , e5DOI: ( /j.jtcvs ) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

9 Figure E3 Survey results for postoperative imaging follow-up of type A aortic dissection. A, Time of first baseline aortic imaging. B, Aortic imaging interval for stable chronic dissection. C, Primary modality to image the distal aorta. CTA, Computed tomography angiography; MRA, magnetic resonance angiography. The Journal of Thoracic and Cardiovascular Surgery  , e5DOI: ( /j.jtcvs ) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

10 Influence of aortic surgical volume on cerebral protection strategies in acute type A dissection.
The Journal of Thoracic and Cardiovascular Surgery  , e5DOI: ( /j.jtcvs ) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

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