Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Nov;86(4):538-548.
doi: 10.18999/nagjms.86.4.538.

Number and mortality of aortic surgery in Japan

Akihiko Usui  1 , Rena Usui  1 , Shunsuke Nakata  1
Affiliations
Review

Number and mortality of aortic surgery in Japan

Akihiko Usui et al. Nagoya J Med Sci. 2024 Nov.

Abstract

According to the Japanese Association for Thoracic Surgery annual surgery survey, the number of aortic surgery has been increasing constantly in the last two decades, with the rates approximately doubling in each decade (5,167, 11,956, and 22,708 cases in 1999, 2009, and 2019, respectively). In 2019, aortic surgery was performed for 11,036 (49%) nondissecting unruptured aneurysm, 730 (3%) ruptured aneurysm, 6,351 (28%) acute type A aortic dissection, 1,412 (6%) chronic type A aortic dissection, 2,385 (11%) acute type B aortic dissection, and 703 (3%) chronic type B aortic dissection cases. The outcomes have been improving annually. From 1999 to 2019, the hospital mortality rates decreased significantly in each case: nondissecting unruptured aneurysm, 9.8% to 4.2%; ruptured aneurysm, 38.5% to 19.7%; acute type A aortic dissection, 18.7% to 10.4%; chronic type A aortic dissection, 7.2% to 4.5%; acute type B aortic dissection, 25.2% to 9.8%; and chronic type B aortic dissection, 7.5% to 3.4%. Furthermore, stent graft, a new technology developed in 1990, was performed in 35%, 53%, 1%, 21%, 62%, and 75% of cases mentioned above, respectively, in 2019. The widespread use of stent graft greatly contributed to the increased number of aortic surgeries and improvement of surgical outcomes.

Keywords: aneurysm; aortic dissection; aortic surgery; stent graft; thoracic endovascular aortic repair.

PubMed Disclaimer

Conflict of interest statement

The authors declare that there is no conflict of interest.

Figures

Fig. 1
Fig. 1
Number of aortic surgeries for each disease
Fig. 2
Fig. 2
Hospital mortality rates according to disease in patients undergoing aortic surgery
Fig. 3
Fig. 3
Procedures performed for nondissecting unruptured aneurysms The black and gray arrows indicate the approval of commercially available stent grafts and open stent grafts, respectively. Ao: aorta Asc. Ao: ascending aorta Dec. Ao: descending aorta TEVAR: thoracic endovascular aortic repair Open SG: open stent graft
Fig. 4
Fig. 4
Procedures performed for nondissecting, ruptured aneurysms The black and gray arrows indicate the approval of commercially available stent grafts and open stent grafts, respectively. Ao: aorta Asc. Ao: ascending aorta Dec. Ao: descending aorta TEVAR: thoracic endovascular aortic repair Open SG: open stent graft
Fig. 5
Fig. 5
Procedures performed for acute type A aortic dissection Asc. Ao: ascending aorta Dec. Ao: descending aorta TAAA: thoracoabdominal aorta TEVAR: thoracic endovascular aortic repair Open SG: open stent graft
Fig. 6
Fig. 6
Procedures performed for acute type B aortic dissection Black, gray, and white arrows show the approval of commercially available stent grafts, open stent grafts, and stent grafts for aortic dissection, respectively. Asc. Ao: ascending aorta Dec. Ao: descending aorta TAAA: thoracoabdominal aorta TEVAR: thoracic endovascular aortic repair Open SG: open stent graft
Fig. 7
Fig. 7
Procedures performed for chronic type A aortic dissection Black, gray, and white arrows show the approval of commercially available stent grafts, open stent grafts, and stent grafts for aortic dissection, respectively. Asc. Ao: ascending aorta Dec. Ao: descending aorta TAAA: thoracoabdominal aorta TEVAR: thoracic endovascular aortic repair Open SG: open stent graft
Fig. 8
Fig. 8
Procedures performed for chronic type B aortic dissection Black, gray, and white arrows show the approval of commercially available stent grafts, open stent grafts, and stent grafts for aortic dissection, respectively. Asc. Ao: ascending aorta Dec. Ao: descending aorta TAAA: thoracoabdominal aorta TEVAR: thoracic endovascular aortic repair Open SG: open stent graft
See this image and copyright information in PMC

References

    1. Committee for Scientific Affairs, The Japanese Association for Thoracic Surgery, Shimizu H, Okada M, et al. Thoracic and cardiovascular surgeries in Japan during 2018: annual report by the Japanese Association for Thoracic Surgery. Gen Thorac Cardiovasc Surg. 2021;69(1):179–212. doi:10.1007/s11748-020-01460-w. - DOI - PMC - PubMed
    1. Committee for Scientific Affairs, The Japanese Association for Thoracic Surgery, Minatoya K, Sato Y, et al. Thoracic and cardiovascular surgeries in Japan during 2019: annual report by the Japanese Association for Thoracic Surgery. Gen Thorac Cardiovasc Surg. 2023;71(10):595–628. doi:10.1007/s11748-023-01945-4. - DOI - PMC - PubMed
    1. Parodi JC. Endovascular repair of abdominal aortic aneurysms and other arterial lesions. J Vasc Surg. 1995;21(4):549–555;discussion 556–557. doi:10.1016/S0741-5214(95)70186-9. - DOI - PubMed
    1. Kato M, Ohnishi K, Kaneko M, et al. New graft-implanting method for thoracic aortic aneurysm or dissection with a stented graft. Circulation. 1996;94(9 Suppl):II188–II193. - PubMed
    1. Czerny M, Schmidli J, Adler S, et al. Current options and recommendations for the treatment of thoracic aortic pathologies involving the aortic arch: an expert consensus document of the European Association for Cardio-Thoracic surgery (EACTS) and the European Society for Vascular Surgery (ESVS). Eur J Cardiothorac Surg. 2019;55(1):133–162. doi:10.1093/ejcts/ezy313. - DOI - PubMed

LinkOut - more resources