Diagnostic Imaging for Acute Aortic Dissection: Imaging Sensitivity and Preference Revisited

Mauban, Erika C.; Pyeritz, Reed E.; Hutchison, Stuart; Ota, Takeyoshi; Upchurch, Gilbert R.; Nour, Khaled; Taylor, Bradley S.; Braverman, Alan C.; Montgomery, Daniel; Nienaber, Christoph; Isselbacher, Eric M.; Pappas, Patroklos; DiScipio, Anthony W.; Eagle, Kim A.; Pape, Linda; Gilon, Dan

doi:10.1016/s0735-1097(18)32614-7

Cited by 3 publications

(4 citation statements)

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“…Previous studies have shown that when D-dimer reaches a cut-off value of 500 ug/L within 24 h of onset, the sensitivity of diagnosing acute aortic dissection is 51.7% and the specificity ranges from 32.8% to 89.2% [26] ; compellingly, such an increase in D-dimer is associated with increased in-hospital mortality [27] . Other biomarkers useful in the diagnosis and evaluation of aortic dissection are soluble growth-stimulating gene-2 protein which is associated with cardiovascular injury [28] , C-reactive protein reflecting inflammatory activity, certain microRNAs (miRNAs) in plasma, such as miR-15a [29] , and calmodulin reflecting vascular interstitial damage. Studies have shown that plasma C-reactive protein is an indicator of poor prognosis in patients with aortic dissection [30] .…”

Section: Discussionmentioning

confidence: 99%

Multiorgan trauma with rare fall-related aortic dissection: case report and review of the literature

2022

IJFM

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Multiorgan trauma that includes aortic dissection most frequently results from car crashes, which is fatal in up to 90% of these patients. Rarely, similar thoracic aortic injury can be caused by falls from significant height. Such a fall in a 43-year-old Chinese man caused multiorgan trauma including multiple fractures and aortic dissection. After immediate evaluation and stabilization of the patient's status, emergency repair of the aortic dissection was performed followed subsequently by elective surgery for the fractures. The patient was eventually discharged from hospital, and at six months followup, he had returned to normal living conditions. The purpose of this case report was to describe the diagnosis and treatment of this rare presentation of traumatic aortic injury as part of multiorgan trauma. Aortic dissection caused by fall injuries from height is extremely rare in clinical practice and can easily be missed or misdiagnosed.

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Section: Discussionmentioning

confidence: 99%

Multiorgan trauma with rare fall-related aortic dissection: case report and review of the literature

2022

IJFM

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“…ADs are classified according to the time of symptom onset and type of symptom (according to the site of involvement). Regarding the time of symptom onset, they are usually classified as acute (up to 14 days), subacute (15-90 days), and chronic (> 90 days) [ 3 ] Regarding the site of involvement, they are classified as Stanford [ 4 - 9 ] type A (with involvement of the ascending aorta) and type B (without involvement of the ascending aorta) [ 3 - 5 ] .…”

Section: Introductionmentioning

confidence: 99%

“…The main imaging tests used in the diagnosis of AD are transthoracic echocardiogram (TTE), transesophageal echocardiogram (TEE), computed tomography (CT), magnetic resonance imaging (MRI), and aortography. However, CT and MRI have been considered superior to TEE and TTE to assess the extension and involvement of branches in cases of AD, as well as for the diagnosis of IMH, PAU, and traumatic aortic injuries [ 9 ] Figures 1A to 1C show three different views of the aorta from a CT angiotomography.…”

Section: Introductionmentioning

confidence: 99%

“…Acute type A AD has a 50% mortality rate in the first 48 hours if not operated [ 3 , 5 ] Despite improvements in surgical and anesthetic techniques, perioperative mortality (25%) and neurological complications (18%) remain high [ 3 , 9 , 10 ] However, surgery reduces mortality in one month from 90% to 30% [ 3 , 7 , 9 ] The advantage of surgery over conservative treatment is particularly obvious in long-term follow-up [ 5 , 9 ] Based on this evidence, all patients with acute type A AD should be referred to surgery; however, coma, shock secondary to pericardial tamponade, poor coronary or peripheral artery perfusion, and stroke are important predictive factors for postoperative mortality [ 3 , 9 , 10 ] .…”

Section: Introductionmentioning

confidence: 99%

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Management of Acute Type A Aortic Dissection at a Public Cardiac Center in the Northeast Region of Brazil

Bezerra¹,

Lima²,

Salerno³

et al. 2021

Braz J Cardiovasc Surg

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Introduction Aortic diseases are among the most serious cardiovascular diseases; the overall mortality rate due to diseases such as aneurysms and aortic dissections has been estimated at 2.78 per 100,000 persons in 2010, with a higher mortality rate in men than women. Our objective was to evaluate the epidemiological profile of patients with acute type A aortic dissection at a cardiology referral center. Methods A retrospective cross-sectional study was performed at a public cardiac center with 24 patients hospitalized from 1/1/2016 to 12/31/2017 with a confirmed diagnosis of acute type A aortic dissection. Results Twenty (83.3%) out of 24 patients underwent surgery and four (16.7%) did not undergo surgery. Among those who underwent surgery, 10 (50%) died and 10 (50%) were discharged, and all non-operated patients died ( P =0.114) (Fisher's exact test). The male gender predominated (n=19, 79.2%), 86.7% (n=13) of the patients presented body mass index > 25 kg/m 2 , chest pain was found in 91.7% (n=22), and renal failure was present in 45.8% (n=11) of the cases. Hypertension predominated in 91.7% (n=22) and the main exam was aortic angiotomography in 79.2% (n=19) of the cases. Conclusion The study presented a small sample size, making it impossible to associate the factors, although the service was considered a high-volume referral center. It is possible that the delay in arriving at the service and the accomplishment of invasive imaging with the use of contrast agents have aggravated the patients’ condition and have been decisive for the increase in lethality, which requires further studies.

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Management of Type B Aortic Dissection

Khoynezhad

Worthington

Jaber

et al. 2021

Aortic Dissection and Acute Aortic Syndromes

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Diagnostic Imaging for Acute Aortic Dissection: Imaging Sensitivity and Preference Revisited

Cited by 3 publications

References 0 publications

Multiorgan trauma with rare fall-related aortic dissection: case report and review of the literature

Multiorgan trauma with rare fall-related aortic dissection: case report and review of the literature

Management of Acute Type A Aortic Dissection at a Public Cardiac Center in the Northeast Region of Brazil

Management of Type B Aortic Dissection

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