Thoracic aortic aneurysms after acute type a aortic dissection: Necessity for follow-up

1990 ◽  
Vol 49 (4) ◽  
pp. 580-584 ◽  
Author(s):  
Markus Heinemann ◽  
Joachim Laas ◽  
Matthias Karck ◽  
Hans G. Borst
Keyword(s):  
Aortic Dissection ◽  
Type A ◽  
Aortic Aneurysms ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Thoracic Aortic Aneurysms

scholarly journals Aggrecan: a new biomarker for acute type A aortic dissection

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Karl C. König ◽  
Harald Lahm ◽  
Martina Dreßen ◽  
Stefanie A. Doppler ◽  
Stefan Eichhorn ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Troponin T ◽  
Type A ◽  
Aortic Aneurysms ◽  
Aortic Tissue ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Potential Biomarker ◽  
Aortic Pathology ◽  
Creatine Kinase Mb

AbstractAcute type A aortic dissection (ATAAD) constitutes a life-threatening aortic pathology with significant morbidity and mortality. Without surgical intervention the usual mortality rate averages between 1 and 2% per hour. Thus, an early diagnosis of ATAAD is of pivotal importance to direct the affected patients to the appropriate treatment. Preceding tests to find an appropriate biomarker showed among others an increased aggrecan (ACAN) mRNA expression in aortic tissue of ATAAD patients. As a consequence, we investigated whether ACAN is a potential biomarker for diagnosing ATAAD. Mean ACAN protein concentration showed a significantly higher plasma concentration in ATAAD patients (38.59 ng/mL, n = 33) compared to plasma of patients with thoracic aortic aneurysms (4.45 ng/mL, n = 13), patients with myocardial infarction (11.77 ng/mL, n = 18) and healthy volunteers (8.05 ng/mL, n = 12). Cardiac enzymes like creatine kinase MB and cardiac troponin T showed no correlation with ACAN levels in ATAAD patients. Receiver-operator characteristics (ROC) curve analysis for ATAAD patients versus control subjects an optimum discrimination limit of ACAN plasma levels at 14.3 ng/mL with a corresponding sensitivity of 97% and specificity of 81%. According to our findings ACAN is a reliable potential biomarker in plasma samples to detect ATAAD with high sensitivity and specificity.

scholarly journals Fate of the preserved aortic root after treatment of acute type A aortic dissection: 23-year follow-up

2013 ◽  
Vol 146 (6) ◽  
pp. 1456-1460 ◽  
Author(s):  
Angelo M. Dell'Aquila ◽  
Giovanni Concistrè ◽  
Alina Gallo ◽  
Stefano Pansini ◽  
Alessandro Piccardo ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Aortic Root ◽  
Type A ◽  
Acute Type ◽  
Type A Aortic Dissection

scholarly journals Florida Sleeve is a Safe and Effective Technique for Valve Salvage in Acute Stanford Type A Aortic Dissection

2021 ◽  
Author(s):  
Mahmoud Alhussaini ◽  
Eric Jeng ◽  
Tomas Martin ◽  
Amber Filion ◽  
Thomas Beaver ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Dissection ◽  
Aortic Root ◽  
Type A ◽  
Long Term Results ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Valve Sparing

Objective: Valve-sparing root replacement is commonly used for management of aortic root aneurysms in elective setting, but its technical complexity hinders its broader adoption for acute Type-A Aortic Dissection (ATAAD). The Florida Sleeve (FS) procedure is a simplified form of valve sparing aortic root reconstruction that does not require coronary reimplantation. Here, we present our outcomes of the Florida Sleeve (FS) repair in patients with dilated roots in the setting of an ATAAD. Methods: We retrospectively reviewed 24 consecutive patients (2002-2018) treated with FS procedure for ATAAD. Demographic, operative, and postoperative outcomes were queried from our institutional database. Long term follow-up was obtained from clinic visits for local patients, and with telephone and telehealth measures otherwise. Results: Mean age was 49 ± 14 years with 19 (79%) males. Marfan syndrome was present in 4 (16.7%) patients and 14 (58.3) had ≥2+ aortic insufficiency (AI). Nine (37.2%) had preoperative mal-perfusion or shock. The FS was combined with hemi-arch replacement in 15 (62.5%) patients and a zone-2 arch replacement in 9 (37.5%) patients. There were 2 (8.3%) early postoperative mortalities. Median follow-up period was 46 months (range; 0.3-146). The median survival of the entire cohort was 143.4 months. One patient (4.2%) required redo aortic valve replacement for unrelated aortic valve endocarditis at 30 months postoperatively. Conclusion: FS is simplified and reproducible valve-sparing root repair. In appropriate patients, it can be applied safely in acute Stanford type-A aortic dissection with excellent early and long-term results.

Aortic Valve Function at Medium-term Follow-up after Resuspension During Repair of Acute Type A Aortic Dissection. Royal Brompton and Harefield Hospitals, Experience

2019 ◽  
Vol 3 (sup1) ◽  
pp. 66-66
Author(s):  
Alessia Gambaro ◽  
Marco Morosin ◽  
Micheal Murphy ◽  
John Pepper ◽  
Jullien Gaer ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Dissection ◽  
Type A ◽  
Acute Type ◽  
Medium Term ◽  
Type A Aortic Dissection ◽  
Valve Function

scholarly journals Early Spontaneous Resolution of an Iatrogenic Acute Type A Aortic Dissection

Aorta ◽  
2016 ◽  
Vol 04 (06) ◽  
pp. 235-239
Author(s):  
Mohammad Zafar ◽  
Philip Pang ◽  
Glen Henry ◽  
Bulat Ziganshin ◽  
Maryann Tranquilli ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
Type A ◽  
Type I ◽  
Acute Type ◽  
Computed Tomography Scan ◽  
Descending Aorta ◽  
Type A Aortic Dissection ◽  
Tomography Scan

AbstractAcute aortic dissection is a rare but devastating complication during cardiac catheterization. We present the case of an elderly female who incurred a Stanford Type A/DeBakey Type I acute aortic dissection extending into the arch vessels and descending aorta likely occurring during right coronary artery engagement for angioplasty. The patient was treated successfully by immediately sealing the entrance of the dissection via the placement of a stent and anti-impulse therapy. Follow-up computed tomography scan showed complete resolution of the dissection within one month.

scholarly journals Extended-arch repair for acute type-A aortic dissection: perioperative and mid-term results

2019 ◽  
Vol 56 (4) ◽  
pp. 714-721 ◽  
Author(s):  
Akash Fichadiya ◽  
Alexander J Gregory ◽  
Vamshi K Kotha ◽  
Eric J Herget ◽  
Holly N Smith ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
False Lumen ◽  
Type A ◽  
Acute Type ◽  
Cross Sectional ◽  
Acute Setting ◽  
Type A Aortic Dissection ◽  
Surgical Complexity ◽  
Permanent Neurological Deficit

Abstract OBJECTIVES: Extended-arch techniques offer the potential to comprehensively treat acute type-A aortic dissection (ATAAD), but add surgical complexity compared to the standard hemiarch technique. This study describes both perioperative and mid-term outcomes following the introduction of an extended-arch technique for ATAAD. METHODS: Ours is a retrospective single-centre observational study of 95 consecutive patients with ATAAD from 2011 to 2016. The decision to perform extended-arch or hemiarch repair was individualized based on clinical and radiological features. Extended-arch repair was defined as replacement of the ascending aorta and arch with reimplantation of head vessels with or without distal endovascular extension. Clinical follow-up was 100% complete. Cross-sectional double-oblique measurements were performed for aortic remodelling analysis. RESULTS: Extended-arch (n = 28) and hemiarch (n = 67) repair resulted in a in-hospital mortality of 10% (n = 3) and 10%, (n = 7), and permanent neurological deficit rate of 7% and 12%, respectively. At a mean imaging follow-up duration of 2.7 ± 1.5 years, false lumen thrombosis was achieved in 57% and 9% of patients undergoing extended-arch and hemiarch repair, respectively. Rate of growth in the proximal descending aorta was 0.7 ± 2.3 mm/year in the extended-arch group vs 2.7 ± 3.9 mm/year in the hemiarch group. At a mean clinical follow-up time of 3.0 ± 1.6 years, open surgical aortic reoperation was 0% in the extended-arch group and 22% in the hemiarch group. CONCLUSIONS: Extended-arch repair of ATAAD can be introduced in the acute setting without increase in perioperative mortality or morbidity. At mid-term follow-up, extended-arch for ATAAD improves aortic remodelling and reduces the need for open surgical reoperation.

scholarly journals Outcomes after surgery for acute type A aortic dissection in “non-Marfan syndrome” patients with long life expectancy: A 24-year follow-up

2017 ◽  
Vol 110 (1) ◽  
pp. 14-25 ◽  
Author(s):  
Alessandro Piccardo ◽  
Tommaso Regesta ◽  
Alexandre Le Guyader ◽  
Nicola Di Lorenzo ◽  
François Bertin ◽  
...  
Keyword(s):  
Life Expectancy ◽  
Aortic Dissection ◽  
Marfan Syndrome ◽  
Type A ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Long Life

scholarly journals LONG-TERM FOLLOW-UP IN MARFAN PATIENTS AFTER SUCCESSFUL SURGERY FOR ACUTE TYPE A AORTIC DISSECTION. THE IRAD EXPERIENCE

2012 ◽  
Vol 59 (13) ◽  
pp. E1900
Author(s):  
Amit Korach ◽  
Marco Di Eusanio ◽  
Kevin Greason ◽  
Daniel Montgomery ◽  
Matthias Voehringer ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Type A ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Long Term Follow Up

scholarly journals Preoperative Predictors of Adverse Clinical Outcome in Emergent Repair of Acute Type A Aortic Dissection in 15 Year Follow Up

2021 ◽  
Vol 10 (22) ◽  
pp. 5370
Author(s):  
Miriam Freundt ◽  
Philipp Kolat ◽  
Christine Friedrich ◽  
Mohamed Salem ◽  
Matthias Gruenewald ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Aortic Dissection ◽  
Hospital Mortality ◽  
Neurological Deficit ◽  
Prolonged Mechanical Ventilation ◽  
Type A ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Acute Renal Insufficiency

Background: Acute type A aortic dissection (AAAD) has high mortality. Improvements in surgical technique have lowered mortality but postoperative functional status and decreased quality of life due to debilitating deficits remain of concern. Our study aims to identify preoperative conditions predictive of undesirable outcome to help guide perioperative management. Methods: We performed retrospective analysis of 394 cases of AAAD who underwent repair in our institution between 2001 and 2018. A combined endpoint of parameters was defined as (1) 30-day versus hospital mortality, (2) new neurological deficit, (3) new acute renal insufficiency requiring postoperative renal replacement, and (4) prolonged mechanical ventilation with need for tracheostomy. Results: Total survival/ follow-up time averaged 3.2 years with follow-up completeness of 94%. Endpoint was reached by 52.8%. Those had higher EuroSCORE II (7.5 versus 5.5), higher incidence of coronary artery disease (CAD) (9.2% versus 3.2%), neurological deficit (ND) upon presentation (26.4% versus 11.8%), cardiopulmonary resuscitation (CPR) (14.4% versus 1.6%) and intubation (RF) before surgery (16.9% versus 4.8%). 7-day mortality was 21.6% versus 0%. Hospital mortality 30.8% versus 0%. Conclusions: This 15-year follow up shows, that unfavorable postoperative clinical outcome is related to ND, CAD, CPR and RF on arrival.

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