scholarly journals Case Report: Are We Witnessing an Increase of Chronic Ascending Aortic Dissection as a Collateral Effect to the COVID-19 Pandemic?

2021 ◽  
Vol 8 ◽  
Author(s):  
Arnaud Lyon ◽  
Ziyad Gunga ◽  
Lars Niclauss ◽  
Valentina Rancati ◽  
Piergiorgio Tozzi
Keyword(s):  
Case Report ◽  
Aortic Dissection ◽  
Ct Scan ◽  
Type A ◽  
Ascending Aorta ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Delayed Treatment ◽  
Lower Limb Pain ◽  
Life Threatening

Background: The COVID-19 (coronavirus disease 2019) pandemic is reducing health care accessibility to non–life-threatening diseases, thus hiding their real incidence. Moreover, the incidence of potentially fatal conditions such as acute type A aortic dissection seems to have decreased since the pandemic began, whereas the number of cases of chronic ascending aortic dissections dramatically increased. We present two patients whose management has been affected by the exceptional sanitary situation we are dealing with.Case report: A 70-year-old man with chest pain and an aortic regurgitation murmur had his cardiac workup delayed (4 months) because of sanitary restrictions. He was then diagnosed with chronic type A aortic dissection and underwent urgent replacement of ascending aorta and aortic root. The delay in surgical treatment made the intervention technically challenging because the ascending aorta grew up to 80 mm inducing strong adhesions and chronic inflammation. The second case report concerns a 68-year-old woman with right lower-limb pain who was diagnosed with deep vein thrombosis. However, a CT scan to exclude a pulmonary embolism could not be realized until 5 months later because of sanitary restrictions. When she eventually got the CT scan, it fortuitously showed a chronic dissection of the ascending aorta. She underwent urgent surgery, and the intervention was challenging because of adhesions and severe inflammation.Conclusion: Delayed treatment due to sanitary restrictions related to COVID-19 pandemic is having a significant impact on the management of potentially life-threatening conditions including type A aortic dissection. We should remain careful to avoid COVID-19 also hitting patients who are not infected with the virus.

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 Early misdiagnosis of acute aortic dissection: A case report and analysis of the causes

2016 ◽  
Vol 4 (1) ◽  
pp. 15
Author(s):  
Xiao-yan Chen ◽  
Fan-liang Kong ◽  
Tong-guo Wu
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Case Report ◽  
Aortic Dissection ◽  
Emergency Room ◽  
Male Patient ◽  
Acute Aortic Dissection ◽  
Type A ◽  
Ascending Aorta ◽  
Type A Aortic Dissection

Type A aortic dissection is a catastrophic clinical entity involving the ascending aorta. In this case report, a patient was admitted to the emergency room with a presentation resembling acute myocardial infarction (AMI) that led to the inappropriate administration of anticoagulant agents or platelet. This is a case report of a 69-year-old male patient with early misdiagnosis and analysis of type A aortic dissection with discussion on the causes of misdiagnosis in light of the literature.

Acute Type A Aortic Dissection at Seven Weeks of Gestation in a Marfan Patient: Case Report

2008 ◽  
Vol 23 (5) ◽  
pp. 569-570 ◽  
Author(s):  
Walid H. Shaker ◽  
Amal A. Refaat ◽  
Mohammed A. Hakamei ◽  
Mohamed F. Ibrahim
Keyword(s):  
Case Report ◽  
Aortic Dissection ◽  
Type A ◽  
Acute Type ◽  
Patient Case ◽  
Type A Aortic Dissection ◽  
Marfan Patient

scholarly journals The results of an entry-oriented strategy for acute type A aortic dissection in octogenarians: an 18-year experience

2020 ◽  
Vol 58 (5) ◽  
pp. 949-956
Author(s):  
Takashi Igarashi ◽  
Yoichi Sato ◽  
Hirono Satokawa ◽  
Shinya Takase ◽  
Hiroki Wakamatsu ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Predictive Factors ◽  
Postoperative Bleeding ◽  
Multivariable Analysis ◽  
Type A ◽  
Ascending Aorta ◽  
Hospital Death ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Direct Discharge

Abstract OBJECTIVES The aim of this study was to evaluate the 18-year results of emergency operations for acute type A aortic dissection, especially in octogenarians. METHODS We reviewed 199 patients who underwent surgical aortic repair of an acute type A aortic dissection from January 2001 to December 2018. If the primary entry existed in the ascending aorta, we limited the extent of the replacement to within the ascending aorta. We analysed the early and late outcomes and identified the predictive factors for in-hospital death and difficulty of direct discharge to home. RESULTS The hospital mortality was 16%. The causes of death were postoperative bleeding (n = 8, 4%), intestinal ischaemia (n = 6, 3%), respiratory failure (n = 5, 3%), systemic inflammatory response syndrome (n = 4, 2%), low output syndrome (n = 3, 2%), sudden death (n = 3, 2%), myonephrotic metabolic syndrome (n = 2, 1%) and stroke (n = 1, 1%). Multivariable analysis revealed that an estimated glomerular filtration rate <30 (P = 0.006), malperfusion (P = 0.001), rupture (P < 0.001) and cross-clamping time (P = 0.003) were independent predictive factors of in-hospital death. Age was not a significant factor for predicting in-hospital death. Ascending aorta replacement (P = 0.013), advanced age (P = 0.002) and prolonged extracorporeal circulation time (P = 0.009) were independent predictive factors of difficulty in direct discharge to home. In the late follow-up period, the 5-year survival and aortic event-free rates were 62.2% and 88.9% in octogenarians, respectively. CONCLUSIONS From the perspective of saving lives, the results of emergency surgery for octogenarians were acceptable. Avoiding the postoperative decline in activities of daily living in octogenarians is a consideration going forward.

scholarly journals Successful Repair of Concomitant Acute Type A Aortic Dissection and Saddle Pulmonary Embolism

Aorta ◽  
2018 ◽  
Vol 06 (01) ◽  
pp. 034-036
Author(s):  
Fabio Ramponi ◽  
Theone Papps ◽  
James Edwards
Keyword(s):  
Pulmonary Embolism ◽  
Aortic Dissection ◽  
Type A ◽  
Management Plan ◽  
Acute Onset ◽  
Correct Identification ◽  
Acute Type ◽  
Pulmonary Embolectomy ◽  
Type A Aortic Dissection ◽  
Life Threatening

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.

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