scholarly journals Outcomes of Preoperative Antiplatelet Therapy in Patients with Acute Type A Aortic Dissection

Author(s):  
Xuan Jiang ◽  
Enyi Shi ◽  
Ruixin Fan ◽  
Ximing Qian ◽  
Hongjia Zhang ◽  
...  

Background: Acute type A aortic dissection(ATAAD) is life-threatening and requires immediate surgery. Sudden chest pain may lead to a risk of misdiagnosis as acute coronary syndrome and may lead to subsequent antiplatelet therapy. We used the Chinese Acute Aortic Syndrome Collaboration Database (AAS) to study the effects of antiplatelet therapy (APT) on clinical outcomes. Methods: The AAS database is a retrospective multicentre database where 31 of 3092 had APT with aspirin or clopidogrel or both before surgery. Before and after propensity score matching, the incidence of complications and mortality was compared between APT and non-APT patients by using a logistic regression model. The sample remaining after PSM was 30 in the APT group and 80 in the non-APT group. Results: The sample remaining after matching was 30 in the APT group and 80 in the non-APT group. We found 10 cases with percutaneous coronary intervention in the APT group(33.3%). The APT group received more volume of packed red blood cell (RBC), 8.4±6.05 units; plasma, 401.67±727 ml, and platelet transfusion(14.07±8.92 units). The drainage volume was much more in the APT group( 5009.37±2131.44ml, P=0.004). Mortality was higher in APT group(26% vs 10%, P=0.027). The preoperative APT was independent predictor of mortality(OR 6.808, 95% CI1.554-29.828, P = 0.011). Conclusion: APT prior to ATAAD repair was associated with more transfusions and higher early mortality. The timing of surgery should be carefully considered based on the patient’s status and the surgeon’s experience.

2014 ◽  
Vol 17 (4) ◽  
pp. 196
Author(s):  
Erhan Kaya ◽  
Halit Yerebakan ◽  
Daniel Spielman ◽  
Omer Isik ◽  
Cevat Yakut

Occlusion of a coronary artery by an acute type A aortic dissection presents a life-threatening emergency that is rarely seen and easy to misdiagnose. We present the case of a 75-year-old male who experienced sudden onset of severe left-sided chest pain due to an acute type A aortic dissection that obstructed the right coronary artery. Following an initial misdiagnosis of acute coronary syndrome, imaging revealed the presence of an aortic dissection. An emergency modified Bentall procedure was performed, in which the damaged aorta and aortic valve were replaced.


Author(s):  
Xuan Jiang ◽  
Fareed Khan ◽  
Enyi Shi ◽  
Ruixin Fan ◽  
Ximing Qian ◽  
...  

Aorta ◽  
2018 ◽  
Vol 06 (01) ◽  
pp. 034-036
Author(s):  
Fabio Ramponi ◽  
Theone Papps ◽  
James Edwards

AbstractPatients presenting with acute onset of chest pain require prompt diagnosis and rapid establishment of a management plan. Acute aortic dissection and acute pulmonary embolism are life-threatening emergencies that can mimic each other at presentation. Correct identification of this uncommon scenario is crucial to initiate the appropriate interventions. The authors present a unique case of concomitant acute type A aortic dissection and acute saddle pulmonary embolism; the patient underwent successful aortic repair and pulmonary embolectomy.


2021 ◽  
Author(s):  
Xiaofeng Xu ◽  
Yunqing Cheng ◽  
Juntao Kuang ◽  
Xuejun Xie ◽  
Jinsong Huang ◽  
...  

Abstract BackgroundHeart transplantation is a major method in the treatment of end-stage heart disease. Acute type A aortic dissection is a rare and life-threatening disease requiring emergency surgery. Although surgical treatment has achieved certain progress in terms of techniques and equipment in the recent years, the surgical mortality rate is still as high as 25%. It is very rare for patients with end-stage heart disease to simultaneously contract aortic dissection. This study will explore the main points of care after end-stage heart disease combined with aortic dissection.ResultsThe cold ischemic times of the donor heart of the two patients were 340 min and 361 min, and the cardiopulmonary bypass times were 381 min and 411 min. Both were successfully operated and discharged uneventfully. ConclusionsThe combination of heart transplantation with aortic dissection surgery is complicated and is prone to multiple postoperative complications. The nursing staff is required to master the main points of care after heart transplantation and aortic dissection, observe problems in a timely manner, intervene early, and promote the patient’s recovery.


Author(s):  
Rehan Shahid ◽  
◽  
Adnan Izhar ◽  
Ali Husnain ◽  
Anum Sohail ◽  
...  

Aortic dissection is intimal tear in aorta and collection of blood in between the layers of aortic wall. The incidence of acute type A aortic dissection is between 2.1 and 16.3 per 100,000 persons [1]. Aortic dissection is an infrequent but potentially life threatening complication of pregnancy with most of the cases occurring in third trimester and post-partum period [2]. The most important predisposing factors to aortic dissection are Marfan, Ehlers-Danlos, Turner and Loeys-Dietz syndromes [3]. However, the non sporadic cases can also occur in pregnancy [4].


2016 ◽  
Vol 45 (5) ◽  
pp. 254-257 ◽  
Author(s):  
Muneaki Yamada ◽  
Yasuyuki Kato ◽  
Aya Takahashi ◽  
Daisuke Shiomi ◽  
Hiroshi Kiyama

2016 ◽  
Vol 20 (2) ◽  
pp. 117 ◽  
Author(s):  
S. Yu. Boldyrev ◽  
V. I. Kaleda ◽  
A. M. Trishina ◽  
Z. E. Tekueva ◽  
E. S. Dumanyan ◽  
...  

<p>Bleeding after surgery for acute aortic dissection in patients who receive antithrombotic therapy for incorrect diagnosis of acute coronary syndrome is a serious challenge for the surgical team. In this setting, additional control of bleeding may be achieved by using a modified Cabrol shunt. In this report we present our experience in acute Type A aortic dissection surgery.</p>


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