Role and Results of Surgery in Acute Type B Aortic Dissection

Trimarchi, Santi; Nienaber, Christoph; Rampoldi, Vincenzo; Myrmel, Truls; Suzuki, Toru; Bossone, Eduardo; Tolva, Valerio; Deeb, Michael; Upchurch, Gilbert R.; Cooper, Jeanna V.; Fang, Jianming; Isselbacher, Eric M.; Sundt, Thoralf M.; Eagle, Kim A.

doi:10.1161/circulationaha.105.000620

Cited by 258 publications

(215 citation statements)

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“…The overall mortality rate of surgical repair for type B dissection is around 30%, reaching 50% in cases where such patients undergo surgery in emergency situations (3) . The EUROSTAR registry presented oneyear survival rate of 90% in patients with dissection, while in the series from the Arizona Heart Institute the one-year survival rate was 85% (8,14) .…”

Section: (7)mentioning

confidence: 99%

“…The mortality associated with surgical correction of type B acute dissection ranges from 30% to 80% in cases of renal or mesenteric ischemia. Endovascular therapy can offer techniques of reperfusion of ischemic vascular beds in complicated dissections, with lower risks than those in open surgery (3) . Aortic dissection and TAAs represent conditions with sometimes catastrophic consequences.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Tratamento endovascular das doenças da aorta torácica: análise dos resultados de um centro

Novero¹,

Metzger²,

Obregon³

et al. 2012

Radiol Bras

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Objective: To analyze treatment outcomes in a consecutive series of patients submitted to endovascular treatment of thoracic aortic disease. Technical success, therapeutic success, morbimortality, rate of perioperative complications and reinterventions were taken into consideration. Materials and Methods: The present retrospective study was developed in a reference center in the period from January 2010 to July 2011, involving patients submitted to endovascular treatment of thoracic aortic disease. The study population was divided into two groups: group 1 (G1) -true thoracic aortic aneurysms, aortic ulcer and pseudoaneurysm; group 2 (G2) -chronic type B aortic dissection. Results: Out of a total of 55 patients, 29 belonged to the G1 and 26 to the G2 group. Mean ages were 66.8 ± 10 and 56.4 ± 7 years, respectively. The technical and therapeutic success reached respectively 86.3% and 68.6% in G1 and 100% and 74% in G2. The perioperative mortality rate was 10.3% in G1 and 19.3% in G2. The reintervention rate was 10.3% in G1 and 15.3% in G2. Conclusion: In the present study, the endovascular treatment of thoracic aortic disease proved to be a feasible method associated with acceptable rate of complications. Keywords: Aneurysm; Vascular graft; Atherosclerosis.Objetivo: Analisar os resultados do tratamento de uma série consecutiva de pacientes submetidos a tratamento endovascular de doenças da aorta torácica. Foram observados o sucesso técnico, o sucesso terapêutico, a morbimortalidade e a taxa de complicações perioperatórias e de reintervenções. Materiais e Métodos: Estudo retrospectivo, realizado em um centro de referência, no período de janeiro de 2010 a julho de 2011, em que foram analisados pacientes submetidos a correção endovascular de doenças da aorta torácica. A população foi dividida em dois grupos: grupo 1 (G1) -aneurismas de aorta torácica verdadeiros, úlcera aórtica e pseudoaneurisma; grupo 2 (G2) -dissecção aórtica tipo B crônica. Resultados: Em um total de 55 pacientes tratados, 29 pertenciam ao G1 e 26, ao G2. As idades médias foram 66,8 ± 10 e 56,4 ± 7 anos, respectivamente. Os sucessos técnico e terapêutico foram, respectivamente, 86,3% e 68,6% no G1 e 100% e 74% no G2. A mortalidade perioperatória foi 10,3% no G1 e 7,6% no G2, com taxa de mortalidade anual de 10,3% no G1 e de 19,3% no G2. As taxas de reintervenções foram 10,3% e 15,3%, respectivamente. Conclusão: Em nosso estudo, o tratamento endovascular das doenças da aorta torácica demonstrou ser um método viável e associado a aceitáveis taxas de complicações. Unitermos: Aneurisma; Prótese vascular; Aterosclerose. . Aortic dissection is the most feared condition of the aorta and is twice as frequent as aortic rupture. The mortality rate associated with dissection ranges between 1% and 2% per hour, during the first 48 hours. Risk factors frequently associated with such condition include hypertension, cardiovascular and respiratory diseases. Dissection is three times more frequent in men than in women. The most common entry 7. PhD, Head

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Section: (7)mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Tratamento endovascular das doenças da aorta torácica: análise dos resultados de um centro

Novero¹,

Metzger²,

Obregon³

et al. 2012

Radiol Bras

View full text Add to dashboard Cite

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“…Independent predictors of surgical mortality were age older than 70 years and preoperative shock/hypotension. 63 …”

Section: Surgical Therapy In Type B Acute Aortic Syndromesmentioning

confidence: 99%

Acute Aortic Syndromes and Thoracic Aortic Aneurysm

Ramanath

Sundt

et al. 2009

Mayo Clinic Proceedings

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192

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Acute and chronic aortic diseases have been diagnosed and studied by physicians for centuries. Both the diagnosis and treatment of aortic diseases have been steadily improving over time, largely because of increased physician awareness and improvements in diagnostic modalities. This comprehensive review discusses the pathophysiology and risk factors, classification schemes, epidemiology, clinical presentations, diagnostic modalities, management options, and outcomes of various aortic conditions, including acute aortic dissection (and its variants intramural hematoma and penetrating aortic ulcers) and thoracic aortic aneurysms. Literature searches of the PubMed database were conducted using the following keywords: aortic dissection, intramural hematoma, aortic ulcer, and thoracic aortic aneurysm. Retrospective and prospective studies performed within the past 20 years were included in the review; however, most data are from the past 15 years. and studied by physicians for centuries. Descriptions of such pathologic conditions of the aorta as aneurysm and dissection date back as early as the 2nd century during the time of Galen, whose discoveries were largely made through studies of apes. More "recent" reports were described by Vesalius in 1557, followed by Nichols in 1732, who detailed the process of aortic dissection. In 1761, Morgagni reported detailed pathologic features of a patient with a ruptured aorta. 1 However, our true understanding of aortic pathology began with the dissertation by Shennan 2 in 1934, which included a description of penetrating atheromatous plaques of the thoracic aorta. His report was followed by the first successful management of aortic dissection by DeBakey in 1955. 1 Since then, our knowledge of the pathologic conditions of the aorta has grown considerably and continues to evolve with ongoing research into the pathophysiology of these conditions, technological advances in the modes of detection, and improved therapeutic options. Clinical databases, such as the International Registry of Acute Aortic Dissection (IRAD), the largest current registry for acute aortic syndromes, have also contributed tremendously to our knowledge of acute aortic pathology.For the practicing clinician, knowledge of aortic disease is paramount because patients with aortic conditions contribute significantly to the overall mortality from cardiovascular disease. This review discusses the pathophysiology, epidemiology, presentation, diagnosis, and therapeutic options for several forms of acute and chronic aortic pathology: aortic dissection (including its variants intramural hematoma [IMH] and penetrating atheromatous aortic ulcer) and thoracic aortic aneurysm (TAA). Literature searches were performed of the PubMed database using the following key words: aortic dissection, intramural hematoma, aortic ulcer, and thoracic aortic aneurysm. Retrospective and prospective studies conducted within the past 15 years, along with some data from years prior, were included in this review.

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“…In a study of 1256 patients with acute aortic dissection, an abrupt onset of pain was noted in 83.8% of patients, any type of pain was reported in 92.6% of patients and chest pain in 59.3%. 12 Sudden chest pain can therefore be a symptom of aortic dissection following weakening of aortic walls. The pain can be either in front or behind and usually in the midline.…”

Section: Cardiovascular Managementmentioning

confidence: 99%