Hemiarch vs Extended Arch in Aortic Dissection - a SystemaTic Analysis by Randomized Trial (HEADSTART)

What this Trial Is About

Researchers are evaluating two surgical methods, hemiarch repair and extended arch repair, for patients with acute DeBakey Type 1 aortic dissection, a serious heart condition. This prospective, randomized trial aims to compare patient outcomes, including mortality and the need for additional surgeries, over a three-year follow-up period. The study addresses uncertainty about the best surgical approach and patient selection to improve long-term results and reduce complications. Participants will be randomly assigned to receive either the standard hemiarch repair, which involves replacing the ascending aorta without treating the mid arch or descending aorta, or the extended arch repair, which includes more extensive replacement of the aorta and arch with or without re-implantation of head vessels and a stent graft device. Both procedures follow each participating center's standard practices for anesthesia and brain protection. Clinical and CT imaging data will be collected before surgery, shortly after, and during long-term follow-up. During the study, participants will undergo clinical evaluations and imaging scans to monitor outcomes such as survival, complications, and changes in aortic structure for up to three years. Researchers will track the occurrence of mortality, need for re-intervention, and aortic healing measures like false lumen thrombosis and aortic size changes. This comprehensive data collection aims to clarify which surgical technique offers better patient outcomes over time.

Hemiarch vs Extended Arch in Type 1 Aortic Dissection