Summary
The general characteristics, outcomes and risk factors of the patients with aortic dissection (AD) were evaluated in a single medical center. From January 2002 to December 2008, 284 patients with AD were treated and followed-up at our institution, including 105 cases of type A AD and 179 cases of type B AD. The patients in each type were divided into three groups according to management: medical treatment group (A or B), open surgery group (A or B), and stent-graft group (A or B). The characteristics and follow-up outcomes were compared between the groups or subgroups. The results showed that there was significant difference in the prognosis for type A AD between medical treatment group and open surgery group, but there was no significant difference in the prognosis for type B AD between medical treatment group and stent-graft group. Independent risk factors of follow-up mortality for patients with type A AD included a history of atherosclerosis (HR, 3.807; 95% confidence interval [CI], 1.489 to 7.611; P=0.003), in-hospital hypotension/shock (HR, 4.687; 95% CI, 1.846 to 11.900; P=0.001), in-hospital myocardial ischemia or infarction (HR, 3.734; 95% CI, 1.613 to 8.643; P=0.002), pleural effusion (HR, 2.210; 95% CI, 1.080 to 4.521; P=0.030), branch vessel involvement (HR, 2.747; 95% CI, 1.202 to 6.278; P=0.016) and surgical treatment (HR, 0.177; 95% CI, 0.063 to 0.502; P=0.001). And there were insignificant independent predictors for mortality of the patients with type B AD. It was concluded that there were significant differences in characteristics and one year mortality between type A AD and type B AD, but after one year, there was no significant difference in the mortality and complications of them. There were several discordant risk factors of AD, such as female gender, age, thrombus, abrupt onset of pain that were considered as the risk factors in some papers. And there was no definite risk factor of mortality in this study in the patients with type B AD.
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References
Prêtre R, Von Segesser LK. Aortic dissection. Lancet, 1997,349(9063):1461–1464
Erbel R, Alfonso F, Boileau C, et al. Task force on aortic dissection, European Society of Cardiology. Diagnosis and management of aortic dissection. Eur Heart J, 2001,22(18):1642–1681
Mehta RH, Manfredini R, Hassan F, et al. International Registry of Acute Aortic Dissection (IRAD) Investigators. Chronobiological patterns of acute aortic dissection. Circulation, 2002,106(9):1110–1115
Manfredini R, Boari B, Gallerani M, et al. Chronobiology of rupture and dissection of aortic aneurysms. J Vasc Surg, 2004,40(2):382–388
Miller DC. Valve-sparing aortic root replacement: current state of the art and where are we headed? Ann Thorac Surg, 2007,83(2):S736–S739
Hado HS, Scarpello JH, Barton T, et al. A case of thoracic aortic dissection presenting as lateral pleuritic chest pain. Emerg Med J, 2005,22(3):229–230
Willoteaux S, Lions C, Gaxotte V, et al. Imaging of aortic dissection by helical computed tomography (CT). Eur Radiol, 2004,14(11):1999–2008
Mestres CA, Fernández C, Josa M, et al. Hybrid antegrade repair of the arch and descending thoracic aorta with a new integrated stent-Dacron graft in acute type A aortic dissection: a look into the future with new devices. Interact Cardiovasc Thorac Surg, 2007,6(2):257–259
Herold U, Tsagakis K, Kamler M, et al. Change of paradigms in the surgical treatment of complex thoracic aortic disease. Herz, 2006,31(5):434–442
Tsai TT, Fattori R, Trimarchi S, et al. Long-term survival in patients presenting with type B acute aortic dissection. Circulation, 2006,114(21):2226–2231
Mehta RH, Suzuki T, Hagan PG, et al. Predicting death in patients with acute type A aortic dissection. Circulation, 2002,105(2):200–206
Hata N, Tanaka K, Imaizumi T, et al. Clinical significance of pleural effusion in acute aortic dissection. Chest, 2002,121(3):825–830
Suzuki T, Mehta RH, Ince H, et al. Clinical profiles and outcomes of acute type B aortic dissection in the current era: lessons from the International Registry of Aortic Dissection (IRAD). Circulation, 2003,108(1):II312–II317
Christoph A, Rajendra H, Barbara M, et al. Gender-related differences in acute aortic dissection. Circulation, 2004,109(24):3014–3021
Rajendra H, Patrick T, Christoph A, et al. Acute type A aortic dissection in the elderly: clinical characteristics, management, and outcomes in the current Era. J Am Coll Cardiol, 2002,40(4):685–692
Januzzi JL, Isselbacher EM, Fattori R, et al. Characterizing the young patient with aortic dissection: results from the International Registry of Aortic Dissection (IRAD). J Am Coll Cardiol, 2004,43(4):665–669
Tsai TT, Evangelista A, Nienaber CA, et al. Partial thrombosis of the false lumen in patients with acute type B aortic dissection. N Engl J Med, 2007,357(4): 349–359
Macrina F, Puddu PE, Sciangula A, et al. Long-term mortality prediction after operations for type A ascending aortic dissection. J Cardiothorac Surg, 2010,5(1): 42–48
Shinohara T, Suzuki K, Okada M, et al. Soluble elastin fragments in serum are elevated in acute aortic dissection. Arterioscler Thromb Vasc Biol, 2003,23(10): 1839–1844
Eggebrecht H, Naber CK, Bruch C, et al. Value of plasma fibrin D-dimers for detection of acute aortic dissection. J Am Coll Cardiol, 2004,44(4):804–809
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Hu, G., Jin, B., Zheng, H. et al. Analysis of 287 patients with aortic dissection: General characteristics, outcomes and risk factors in a single center. J. Huazhong Univ. Sci. Technol. [Med. Sci.] 31, 107–113 (2011). https://doi.org/10.1007/s11596-011-0160-6
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DOI: https://doi.org/10.1007/s11596-011-0160-6