Clinical features and prognosis of patients with acute aortic dissection in China

Abstract

ObjectiveTo evaluate the clinical features, risk factors, and prognostic significance of different Stanford types of acute aortic dissection (AAD).MethodsWe retrospectively analyzed the clinical data and prognostic predictors in 105 patients with AAD (37 with Stanford type A and 68 with Stanford type B) at Tianjin Medical University General Hospital and Tianjin 4th Central Hospital from January 2014 to November 2015.ResultsPatients with Marfan syndrome and bicuspid aortic valve constituted 24.3% and 8.1%, respectively, of patients with type A AAD; these proportions were significantly higher than those of patients with type B AAD (7.4% and 0.0%, respectively). The proportion of iatrogenic causes of type A AAD (8.1%) was significantly higher than that of type B AAD (0.0%). Computed tomography angiography showed that the proportion of involvement of the aortic arch and pericardial effusion (86.5% and 18.9%, respectively) in patients with type A AAD were higher than those in patients with type B AAD (23.5% and 5.9%, respectively). Endovascular treatment was performed in a higher proportion of patients with type B than A AAD (70.6% vs. 5.4%, respectively).ConclusionSystolic blood pressure, pericardial effusion, periaortic hematoma, conservative treatment, and open surgery were independent predictors of increased mortality in patients with AAD.

Clinical features and risk factors of postoperative in-hospital mortality following surgical repair of Stanford type A acute aortic dissection

“…Because the tear may occur in different sites and multiple organs are involved in this type of patients, Stanford type A AAD is more complicated than Stanford type B AAD. It often occurs acutely with rapid progress and poor prognosis, seriously threatening the life of patients [ 8 , 9 ].…”

TG/HDL-C ratio predicts in-hospital mortality in patients with acute type A aortic dissection

“…This results in increased capillary permeability, tissue edema, and ultimately multiple organ failure, resulting in a significant increase in mortality in AAD patients. Previous studies have shown that about 80.0% of patients with aortic dissection also have hypertension [ 19 ]. Hypertension is a major risk factor for dissection rupture and increases the risk of death.…”

Association of serum cystatin C levels with mortality in patients with acute type A aortic dissection

“…AAD is the main cause of cardiovascular morbidity and mortality. Although no epidemiological data have been confirmed, the number of patients with AAD has increased in China in recent years [ 15 ]. ATAAD owns high in-hospital mortality due to potentially fatal complications, such as coronary involvement, even in centers that have extensive expertise and interest in the treatment of high-risk patients [ 16 ].…”