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

Abstract

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.

A bioinformatics analysis of the susceptibility genes in Stanford type A aortic dissection

“…Furthermore, the enriched cell components included the cytoplasm, cell membrane and components of cell membrane, extracellular space, extracellular region, and the junction part of the extracellular region. Finally, the enriched molecular functions included protein linking, signaling molecule sensor activity, chemokine activity, and cytokine receptor binding ( 30 - 32 ). These data indicated that the formation of aortic dissection involves a series of changes in a variety of cytokines, chemokines, and their receptors, leading to gradual changes in cellular ultrastructure that affects the tension resistance of the aortic wall.…”

Discomfort of postoperative patients with aortic dissection after discharge: telephone follow-up analysis of a cross-sectional study

“…Previous hospital-based studies from specialized centers or studies from retrospective registry data indicated that the delay from onset of symptoms to diagnosis could range from 4.3 h to more than 24 h, and delayed diagnosis means patients receive treatment for AD more lately [ 16 , 23 ]. It was confirmed that delayed diagnosis might lead to devastating outcomes (amputations or renal failure) even death [ 25 ]. And our findings supplemented a neglected result that delayed diagnosis could lead to physical discomfort of patients after surgery, which may have a negative impact on patients.…”

A bioinformatics analysis of the susceptibility genes in Stanford type A aortic dissection

“…Gene ontology analysis revealed that the differentially upregulated mRNAs in Stanford type A aortic dissection are involved in a variety of biological processes, especially in inflammatory stimulation and immune response ( 29 membrane and components of cell membrane, extracellular space, extracellular region, and the junction part of the extracellular region. Finally, the enriched molecular functions included protein linking, signaling molecule sensor activity, chemokine activity, and cytokine receptor binding (30)(31)(32). These data indicated that the formation of aortic dissection involves a series of changes in a variety of cytokines, chemokines, and their receptors, leading to gradual changes in cellular ultrastructure that affects the tension resistance of the aortic wall.…”