The future of stenting in patients with type A aortic dissection: a systematic review

Harky, Amer; Chan, Jeremy; MacCarthy‐Ofosu, Beverly

doi:10.1177/0300060519871372

Cited by 13 publications

(8 citation statements)

References 55 publications

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“…Type A involves the ascending aorta, whereas type B includes the remainder of the aorta. 38 Pregnant women undergo haemodynamic and aortic wall changes predisposing them to aortic dissection; therefore, the risks could be higher when preexisting conditions like hypertension and connective tissue disorders coexist with pregnancy. 19 Women with known pre-existing aortic disease and evidence of aortic dilatation before pregnancy are indicated for elective cardiac surgery.…”

Section: Aortic Dissectionmentioning

confidence: 99%

“…Aortic dissection, a rare and life‐threatening condition, that can be classified into Stanford type A and type B. Type A involves the ascending aorta, whereas type B includes the remainder of the aorta 38 . Pregnant women undergo haemodynamic and aortic wall changes predisposing them to aortic dissection; therefore, the risks could be higher when pre‐existing conditions like hypertension and connective tissue disorders coexist with pregnancy 19 .…”

Section: Aortic Dissectionmentioning

confidence: 99%

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Pregnancy and cardiac interventions: What are the optimal management options?

et al. 2020

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Cardiac disease is the leading cause of maternal mortality in the United Kingdom. Major causes of cardiac death in pregnant women include cardiomyopathies, myocardial infarction, ischemic heart disease, and aortic dissection. Uncorrected congenital heart disease and women who have had corrective or palliative surgery may have complicated pregnancies as well. Some women with significant cardiac disease are unable to meet the increased physiological demands of pregnancy. Of these, those who do not respond to medical treatment may require surgical correction such as coronary artery bypass grafting. The risk of cardiac operations for pregnant women is similar to that for nonpregnant women but the fetal mortality rate remains high. Contributing factors to high fetal mortality rates include timing, urgency of operation, and the fetal/fetoplacental response to cardiopulmonary bypass. The aim of this review is to summarize current evidence in utilizing the different management approaches of cardiac issues during pregnancy.

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Section: Aortic Dissectionmentioning

confidence: 99%

Section: Aortic Dissectionmentioning

confidence: 99%

Pregnancy and cardiac interventions: What are the optimal management options?

et al. 2020

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“…More recently, customised, curved, branched, and fenestrated stent grafts have been developed to make it easier to land the graft in the aortic arch obviating the need for supra-aortic revascularization. The pre-curved fenestrated grafts have a 95.8% operative success with a 30-day mortality of 1.6% for acute dissection and aortic arch aneurysms [ 43 ] .…”

Section: Connective Tissue Disordersmentioning

confidence: 99%

The Role of Thoracic Endovascular Aortic Repair (TEVAR) of Thoracic Aortic Diseases in Patients with Connective Tissue Disorders – A Literature Review

Harky

Hussain

MacCarthy‐Ofosu

et al. 2020

Braz J Cardiovasc Surg

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Objective To review the currently available literature to define the role of thoracic endovascular aortic repair (TEVAR) in patients with connective tissue disorders (CTD). Methods A comprehensive electronic database search was performed in PubMed, SCOPUS, Embase, Google scholar, and OVID to identify all the articles that reported on outcomes of utilizing TEVAR in patients with CTD during elective and emergency settings. The search was not limited to time or language of the published study. Results All the relevant studies have been summarized in its correspondence section. The outcomes were analyzed in narrative format. The role of TEVAR has been elaborated as per each study. Currently, there is limited large cohort size studies outlining the use of TEVAR in patients with CTD. The use of endovascular repair in patients with CTD is limited due to progressive aortic dilatations and high possibility of further reinterventions at later stage of life. Conclusion Open repair remains the gold standard method of intervention in young patients with progressive CTD, especially in the setting of acute type A aortic dissection. However, TEVAR can be sought as a reliable alternative in emergency setting of diseases involving the descending thoracic aorta; yet the long-term data needs to be published to support such practice.

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“…However, in the UK there is a lack of centralization of expertise and aortic service provision in all of its forms. Additionally, surgery on MFS patients is not being practiced through a rigorous protocol, which can affect the outcomes between high and low-volume surgeons [12][13][14] .…”

Section: Marfan Syndrome (N=306) Missing Datamentioning

confidence: 99%

Thoracic Aortic Aneurysm Surgery in Marfan Patients: a Perspective from the UK

Harky¹,

Shaw²,

Bashir³

2020

Braz J Cardiovasc Surg

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Objective: Cardiovascular complications in Marfan patients include progressive aortic root dilation which can precipitate acute aortic dissection, ruptured aorta, severe aortic regurgitation, or all the aforementioned. Such complications can be fatal and the cause of death prior to any surgical intervention. We set out to identify the Marfan population in England and Wales and present their surgical outcomes. Methods: A total of 306 patients with Marfan syndrome who underwent aortic root surgery were identified between April 2007 and March 2013 from NICOR database. We examined the perioperative characteristics of such cohort along with in-hospital outcomes and survival. Results: Root and ascending segment procedures on Marfan patients performed in 3.3% of the total cohort by NICOR root surgery patients. The median reported age was 40 years (IQR = 29-49 years) and 100 (32.7%) were female. Of the patients analysed, 17.3% were treated non-electively and 68.6% of them received concomitant valve procedure. The in-hospital mortality was 2.0%. Reoperation for bleeding was required in 8.2% of patients and 1.3% of them suffered a cerebrovascular accident (CVA). Mortality at 1 year was reported as 5.5%. Conclusion: The outcomes of surgery on the root and ascending aorta in Marfan patients in the United Kingdom are satisfactory; however, the overall complexities of this patient population are not well understood and would benefit from further investigations.

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The future of stenting in patients with type A aortic dissection: a systematic review

Cited by 13 publications

References 55 publications

Pregnancy and cardiac interventions: What are the optimal management options?

Pregnancy and cardiac interventions: What are the optimal management options?

The Role of Thoracic Endovascular Aortic Repair (TEVAR) of Thoracic Aortic Diseases in Patients with Connective Tissue Disorders – A Literature Review

Thoracic Aortic Aneurysm Surgery in Marfan Patients: a Perspective from the UK

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