Type A dissection in young patients

Niclauss, Lars; Delay, Dominique; Segesser, Ludwig Karl von

doi:10.1510/icvts.2010.245225

Cited by 20 publications

(14 citation statements)

References 10 publications

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“…In our series, 13 patients (3.5%) were under 40 years old. Our findings were comparable to those of previous studies that found that patients with connective tissue disorders tended to present with AAAD at a younger age . Fourteen (27.5%) of 51 patients had connective tissue disorders, and the prevalence of connective tissue disorders increased with decreasing age.…”

Section: Discussionsupporting

confidence: 90%

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Acute type A aortic dissection repair in younger patients

et al. 2018

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Section: Discussionsupporting

confidence: 90%

“…The majority of patients with acute type A aortic dissection (AAAD) requiring surgical intervention are in their 60s and 70s . However, AAAD repair is sometimes necessary in younger patients . These patients are more likely than older patients to have a genetic component.…”

Section: Introductionmentioning

confidence: 99%

Acute type A aortic dissection repair in younger patients

et al. 2018

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“…As this was not the case, it seems likely that other factors such as the presence of a bicuspid aortic valve and consecutively altered hemodynamics through the valve may well be a leading mechanism of aneurysm formation [11]. In acute type A aortic dissection one would expect a certain percentage of patients with connective tissue disease which was also not the case in this series [12,13]. These findings do further substantiate the need for accurate and early determination of patients being at risk for acute type A aortic dissection.…”

Section: Resultsmentioning

confidence: 98%

Evaluation of the intraoperative specimens of the thoracic and abdominal aorta

Juraszek

Bayer

Dziodzio

et al. 2013

J Cardiothorac Surg

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BackgroundLittle is known about the histological patterns of acute and chronic aortic pathology with regard to medial degeneration, atherosclerosis and aortitis as well as their distribution in different age groups. The aim of the study was to evaluate histopathological findings of intraoperatively gained aortic specimens with regard to the incidence of medial degeneration, atherosclerosis and aortitis.MethodsIntraoperatively gained aortic specimens were evaluated in 151 patients including 83 (55%) aortic aneurysms (65 thoracic, 18 abdominal) and 68 (45%) acute type A aortic dissections. Histological stainings used were hematoxylin and eosin, Van Gieson as well as alcian blue. Patients were stratified according to above and below 65 years of age. High grade medial degeneration represented pooling of mucoid material in the whole aortic wall. High grade atherosclerosis represented severe intimal fibrosis, massive accumulation of macrophages and foam cells or massive calcification of the aortic wall.ResultsMedial degeneration was diagnosed in 106 (70%) patients including 55 (52%) aortic aneurysms and 51 (48%) acute type A aortic dissections. High grade medial degeneration was found in 50% of patients with thoracic aortic aneurysms < 65 years of age vs. 44% in patients ≥ 65 years of age (p = 0.64) and in 36% of patients with thoracic aortic dissections < 65 years of age vs. 14% in patients ≥ 65 years of age (p = 0.07). Atherosclerosis was diagnosed in 71 (47%) patients including 46 (65%) aortic aneurysms and 25 (35%) aortic dissections. High grade atherosclerosis was found in 23% of patients with thoracic aneurysms < 65 years of age vs. 36% in patients ≥ 65 years of age (p = 0.24) and in 13% of patients with aortic dissections < 65 years of age vs. 52% in patients ≥ 65 years of age (p < 0.001). Aortitis was rare (n = 2).ConclusionsMedial degeneration was the most frequent diagnosis in this series of aortic specimens. Medial degeneration was equally common in patients above and below 65 years of age. However in cases with acute type A aortic dissections, high grade atherosclerosis was the leading histopathological diagnosis in patients older than 65 years. Acute type A aortic dissections seem to have different underlying pathologies in different age groups.

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“…The rate of proximal reoperation was reported up to 50% at 10 years [28]. Similarly, young patients experienced a higher rate of proximal reoperation [29]. This problem should not be considered strictly in the light of the longer survival expectancy, the prolonged exposition to aortic complication or an easier acceptance for a redo procedure.…”

Section: Risk Factors Of Proximal Reoperation After Supracoronary Aormentioning

confidence: 99%

Proximal repair in acute type A aortic dissection: The dark side of the root

Malvindi

Morshuis

Paparella

2016

Journal of the Egyptian Society of Cardio-Thoracic Surgery

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There is no agreement regarding the best treatment for proximal repair in acute type A aortic dissection. Isolated replacement of the ascending aorta has been shown effective but can leave patients at a higher risk of further aortic procedures. The interpretation of the results coming from the literature is difficult because of the great variability of the clinical scenarios and the anatomic extension of the dissection. The analysis of the risk factors suggests that the presence of the underlying root pathology and a more extensive involvement of the aortic root should address the surgeon towards a more radical proximal resection.

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Type A dissection in young patients

Cited by 20 publications

References 10 publications

Acute type A aortic dissection repair in younger patients

Acute type A aortic dissection repair in younger patients

Evaluation of the intraoperative specimens of the thoracic and abdominal aorta

Proximal repair in acute type A aortic dissection: The dark side of the root

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