Impact of acute aortic pathology care process reengineering on mortality of type A acute aortic syndrome

• DOI: 10.1093/ehjacc/zuae036.116
• Publication Date: 2024-05-09T00:08:33Z
• Authors: I Ramos Gonzalez-...; C Ferrera; I Vilacosta; A Guerrero; F Gutierrez; J Gonzalez Del Ca...; M J Dominguez; E Alvarez; F Fernandez; I Martinez; J Cobiella; F J Noriega; A Viana-Tejedor; J Perez Villacastin; L Maroto-Castellanos
• Keywords: Acute aortic syndrome; Business process reengineering

Abstract Funding Acknowledgements None. Introduction Type A Acute aortic syndrome (AAS) is a life-threatening disease. Although emergent surgery the treatment of choice, these procedures are highly complex and require high level expertise. Process reengineering has demonstrated prognostic benefit in acute cardiovascular pathology. Purpose The aim present work to assess whether reorganization AAS care an impact on patient prognosis. Methods "Aorta Code" (AC) protocol for AAS-patients’ within network 4 hospitals with tertiary hospital as referral center. common diagnostic algorithm was specifically designed periodical training programs were carried out different emergency departments at hospitals. Once activated, service immediately transfers Cardiovascular Care Unit An Aortic Dissection Team responsible patients’ care. Only two cardiac surgeons vascular performed all surgeries. All patients prospectively consecutively collected type selected analysis. Expected 30-day mortality calculated using GERAADA score. Results From April-2019 April-2023, 113 included. Of them, 75.9% (83) A. 12% (10) died before reaching operating theatre. In 9% (8) sample, rejected due comorbidities unacceptable surgical risk, whom died. Mean age 66.7±13.7 years 71% males. Patients presented significant burden pre-surgical complications: severe regurgitation (35.6%), tamponade (26.8%), shock (32.9%), cardiorespiratory arrest (8.5%), need intubation renal failure (27%), peripheral malperfusion (12.7%) myocardial ischemia (9.52%). AC included risk population, process reorganization, concentration experienced medical team resulted reduction compared expected based (figure). Conclusion management medical-surgical associated improvement prognosis mortality.Pre-surgical complications.