TY - JOUR AU - Kodolitsch, Yskert von AU - Wilson, Oliver AU - Schüler, Helke AU - Larena-Avellaneda, Axel AU - Kölbel, Tilo AU - Wipper, Sabine AU - Rohlffs, Fiona AU - Behrendt, Christian AU - Debus, E. Sebastian AU - Brickwedel, Jens AU - Girdauskas, Evaldas AU - Detter, Christian AU - Bernhardt, Alexander M. AU - Berger, Jürgen AU - Blankenberg, Stefan AU - Reichenspurner, Hermann AU - Ghazy, Tamer AU - Matschke, Klaus AU - Hoffmann, Ralf-Thorsten AU - Weiss, Norbert AU - Mahlmann, Adrian PY - 2017 TI - Warfarin anticoagulation in acute type A aortic dissection survivors (WATAS) JF - Cardiovascular Diagnosis and Therapy; Vol 7, No 6 (December 13, 2017): Cardiovascular Diagnosis and Therapy Y2 - 2017 KW - N2 - Background: Early survivors of acute type A aortic dissection (AAAD) remain at risk for late death and late aortic events. However, the frequency and long-term effects of warfarin anticoagulation on long-term outcome in post-surgical AAAD survivors have not been elucidated. Methods: Two tertiary care centers performed a retrospective observational cohort study of warfarin anticoagulation in AAAD in 243 persons with early survival of surgical repair (WATAS). Serial postoperative tomographic imaging was available in 106 persons. Results: A total of 88 postoperative AAAD survivors (36%) were on long-term warfarin anticoagulation. The indication for anticoagulation was a mechanical aortic prosthesis in 46 (52%), atrial fibrillation in 33 (38%), stroke in 7 (8%), and pulmonary embolism in one (1%). The indication for anticoagulation remained unclear in one person (1%). Survival and aortic event free survival were 98.3±0.01 and 98.7±0.01 at 1 year, and 76.4±0.03 and 91.8±0.02 at 5 years, respectively, with no differences irrespective of warfarin anticoagulation. Multivariate Cox regression analysis established higher age (P Conclusions: Warfarin anticoagulation is frequent in postsurgical AAAD and it is administered for vital indications. Warfarin anticoagulation does not relate to late mortality or to late aortic events. Rapid aortic growth predicts late mortality and late aortic events, but warfarin anticoagulation is not associated with aortic growth. Follow-up tomographic imaging is mandatory for long-term survival after surgical repair of AAAD. UR - https://cdt.amegroups.org/article/view/16906