scholarly journals Low arterial pressure on admission as a predictor of mortality in operated patients with type A aortic dissection

2011 ◽  
Vol 68 (5) ◽  
pp. 410-416 ◽  
Author(s):  
Katica Pavlovic ◽  
Nada Cemerlic-Adjic ◽  
Aleksandra Jovelic ◽  
Dalibor Somer
Keyword(s):  
Blood Pressure ◽  
Aortic Dissection ◽  
Arterial Hypertension ◽  
Type A ◽  
Left Ventricular ◽  
Ascending Aorta ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
History Of ◽  
Aorta Diameter

Background/Aim. Hypertension is a known predictor of proximal aortic dissection, but it is not commonly present in these patients on presentation. The associations between ascending aorta with left ventricular hypertrophy, cardiovascular risk factors and coronary atherosclerosis, and outcome of these patients are not fully elucidated. Methods. This retrospective study included 55 consecutive patients with acute type A aortic dissection treated surgically in our institution during the last 2 years. The diagnosis was based on imaging studies. Diameter of ascending aorta was measured with echocardiography. Results. The mean age of the patients was 55.4 ? 12.19 years, and 72.7% were men. A history of arterial hypertension was present in 76.4% of the patients. Maximal ascending aorta diameter was 4.09 ? 0.59 cm, while patients with frank aneurysm accounted for 5.5%. Systolic blood pressure on admission was < 150 mmHg in 58.2% of the patients. Diastolic blood pressure on admission was < 90 mmHg in 54.5% of the patients. Mean arterial pressure on admission was 104.9 ? 24.6 mmHg. No correlations were demonstrated between maximal ascending aorta diameter and diameter of the left ventricular wall, any obtained risk factor and with coronary artery atherosclerosis (p > 0.05). After six months 11 (20%) patients died, while intrahospital mortality was 72%. According to logistic regression analysis which included traditional risk factors, echo parameters, coronary artery disease and logistic euro scor, mean arterial blood pressure was the independent predictor of a six-month mortality [RR 0.956; CI (0.918-0.994 ); p = 0.024]. Conclusion. In our population the acute type A aortic dissection occurred rarely in the setting of frank ascending aortic aneurysms > 5.0 cm. The majority of patients had a history of arterial hypertension. A history of arterial hypertension was not associated with maximal ascending aorta diameter. Mean arterial blood pressure was the independent predictor of a six-months mortality.

Acute Type A Aortic Dissection Treated Using a Tubular Stent-Graft in the Ascending Aorta and a Multibranched Stent-Graft in the Aortic Arch

2016 ◽  
Vol 24 (1) ◽  
pp. 75-80 ◽  
Author(s):  
Tilo Kölbel ◽  
Christian Detter ◽  
Sebastian W. Carpenter ◽  
Fiona Rohlffs ◽  
Yskert von Kodolitsch ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Stent Graft ◽  
Open Surgery ◽  
Type A ◽  
Ascending Aorta ◽  
Type I ◽  
Acute Type ◽  
Stent Grafts ◽  
Type A Aortic Dissection ◽  
Custom Made

Purpose: To describe the combined use of a tubular stent-graft for the ascending aorta and an inner-branched arch stent-graft for patients with acute type A aortic dissection. Technique: The technique to deploy these modular, custom-made stent-grafts is demonstrated in 2 patients with acute DeBakey type I aortic dissections and significant comorbidities precluding open surgery. Both emergent procedures were made possible by the availability of suitable devices manufactured for elective repair in other patients. After preliminary carotid-subclavian bypass, a long Lunderquist guidewire was introduced from the right femoral artery to the left ventricle for delivery of the Zenith Ascend and Zenith Branched Arch Endovascular Grafts under inflow occlusion. Bridging stent-grafts were delivered to the innominate and left common carotid arteries to connect to the 2 inner branches; the left subclavian artery was occluded. Both cases were technically successful and resulted in exclusion of the false lumen in the ascending aorta. The operating and fluoroscopy times did not exceed those of comparable elective procedures. The patients were rapidly extubated shortly after the procedure and without serious immediate complications. One patient survived 11 months with a satisfactory repair; the other succumbed to complications of recurrent pneumonia after 23 days. Conclusion: Endovascular treatment of patients with acute type A aortic dissection using a combination of tubular and branched stent-grafts in the ascending aorta is feasible and offers an alternative strategy to open surgery.

Acute Type A Aortic Dissection After TAVR in an Octogenarian With Ascending Aorta Aneurysm

2021 ◽  
Author(s):  
Helen Hashemi ◽  
Sahil Khera ◽  
Malcolm Anastasius ◽  
Ismail El-Hamamsy ◽  
Gilbert H.L. Tang ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Type A ◽  
Ascending Aorta ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Aorta Aneurysm

scholarly journals Equations Estimating the Predissected Diameter of the Ascending Aorta for Acute Type A Aortic Dissection

2019 ◽  
Vol 108 (2) ◽  
pp. 481-490 ◽  
Author(s):  
Takashi Yamauchi ◽  
Hiroshi Takano ◽  
Toshiki Takahashi ◽  
Takafumi Masai ◽  
Masayuki Sakaki ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Type A ◽  
Ascending Aorta ◽  
Acute Type ◽  
Type A Aortic Dissection

scholarly journals Acute Type A Aortic Dissection in a 36-Week Pregnant Patient

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Erol Kohli ◽  
Sharhabeel Jwayyed ◽  
Gary Giorgio ◽  
Mary Colleen Bhalla
Keyword(s):  
Aortic Dissection ◽  
Early Recognition ◽  
Type A ◽  
Pregnant Patient ◽  
Acute Type ◽  
Third Trimester ◽  
Type A Aortic Dissection ◽  
Increased Risk ◽  
History Of ◽  
Aortic Dissections

Aortic dissection is a relatively rare yet often fatal condition. Early recognition and treatment are crucial for survival. While the majority of patients who present with aortic dissection are older than 50 years of age and have a history of hypertension, younger patients with connective tissue disease, bicuspid aortic valves, and a family history of aortic dissection are also at an increased risk for developing this condition. A review of the literature revealed a paucity of published cases describing the successful, emergent repair of acute type A aortic dissections in third- trimester gravid patients. We present the case of the successful diagnosis and surgical repair of a 41-year-old female who presented to the emergency department with an acute type A aortic dissection at 36 weeks of gestation.

scholarly journals Successful treatment of an acute type A aortic dissection presented with ST segment elevation on ECG and pericardial tamponade. Case report

2014 ◽  
Vol 155 (44) ◽  
pp. 1763-1767
Author(s):  
Miklós Pólos ◽  
Zoltán Szabolcs ◽  
Astrid Apor ◽  
István Édes ◽  
Erzsébet Paulovich ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Successful Treatment ◽  
Acute Aortic Dissection ◽  
Type A ◽  
Pericardial Tamponade ◽  
Left Ventricular ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
St Segment Elevation ◽  
St Segment

Successful treatment of type A acute aortic dissection depends on the promptness of diagnostic evaluation and therapy. Fast diagnosis can be challenged by numerous complications such as myocardial ischemia, acute aortic insufficiency, and disturbances in organ perfusion and pericardial tamponade. The authors report the case history of a 72-year-old woman, who was admitted after resuscitation with ST segment elevation. Echocardiography revealed acute type A aortic dissection with signs of pericardial tamponade. An emergency operation consisting of the resection of the ascending aorta and the reconstruction of the aortic root was performed, which took six hours from admission until the end of the operation. Follow-up examinations demonstrated good left ventricular function and competent aortic valve. The authors propose that with the development of diagnostic and therapeutic options, faster and less invasive interventions will be introduced in near future for the treatment of acute aortic dissection, which may reduce the morbidity and mortality rates of this lethal illness. Orv. Hetil., 2014, 155(44), 1763–1767.

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