Article
Surgery
Francesco Squizzato, Gustavo S. Oderich, Thomas C. Bower, Bernardo C. Mendes, Manju Kalra, Fahad Shuja, Jill Colglazier, Randall R. DeMartino
Summary: The study found that aortic branch involvement in patients with aortic dissection leads to long-term morbidity, including interventions, aneurysms, malperfusion, etc., but no branch-related deaths. Type BAD aortic dissection, patency of the aortic false lumen, and malperfusion syndrome at presentation are predictive factors for late aortic branch events.
JOURNAL OF VASCULAR SURGERY
(2021)
Article
Cardiac & Cardiovascular Systems
Guang Tong, Zhongchan Sun, Jinlin Wu, Shuang Zhao, Zerui Chen, Donglin Zhuang, Yaorong Liu, Yongchao Yang, Zhichao Liang, Ruixin Fan, Tucheng Sun
Summary: In this study, the safety and efficacy of using the aortic balloon occlusion (ABO) technique for acute type A acute aortic dissection (ATAAD) patients with lower body malperfusion were evaluated. The results showed that ABO technique allowed for arch repair with frozen elephant trunk (FET) under higher temperature and shorter circulatory arrest time. However, ABO technique did not improve perioperative outcomes.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Article
Medicine, General & Internal
Horea Feier, Andrei Grigorescu, Laurentiu Braescu, Lucian Falnita, Marius Sintean, Constantin Tudor Luca, Mihaela Mocan
Summary: The use of the innominate artery for arterial perfusion in type A acute aortic dissection repair leads to better perfusion and superior results.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Cardiac & Cardiovascular Systems
Carlo Mariani, Luca Botta, Alessandro Leone, Giacomo Murana, Marianna Berardi, Giuditta Coppola, Ciro Amodio, Francesco Buia, Luca Di Marco, Davide Pacini
Summary: The study found that the incidence of visceral malperfusion syndrome after Frozen Elephant trunk operations was 6.1%, with a strong correlation with in-hospital mortality. The involvement of aortic branches by the dissection was not a risk factor for malperfusion, while larger post-operative aortic diameters and false lumen thrombosis were independent risk factors for malperfusion and in-hospital mortality.
INTERNATIONAL JOURNAL OF CARDIOLOGY
(2021)
Article
Cardiac & Cardiovascular Systems
Manabu Yamasaki, Hideaki Yoshino, Takashi Kunihara, Koichi Akutsu, Tomoki Shimokawa, Hitoshi Ogino, Mitsuhiro Kawata, Toshiyuki Takahashi, Michio Usui, Kazuhiro Watanabe, Hiroshi Masuhara, Takeshi Yamamoto, Ken Nagao, Morimasa Takayama
Summary: This study found that male sex, use of percutaneous circulatory assist devices, shock, cardiac and cerebral ischemia are independent preoperative risk factors for early mortality after acute type A aortic dissection repair, while cardiac tamponade, cerebral and mesenteric ischemia are independent postoperative risk factors.
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
(2021)
Article
Cardiac & Cardiovascular Systems
Wendan Wang, Lei Wang, Chen Chai, Qi Sun, Yue Yuan, Tiantian Wang, Long Wu, Zehai Tang
Summary: This study aimed to investigate the impact of branch vessel involvement on organ malperfusion and mid-term survival in patients with acute type A aortic dissection (ATAAD). The incidence of organ malperfusion was significantly higher in patients with branch vessel involvement compared with patients without it. Branch vessel involvement had a greater effect on short-term outcomes than mid-term survival, and organ malperfusion was related to a worse prognosis beyond it.
INTERNATIONAL JOURNAL OF CARDIOLOGY
(2023)
Article
Cardiac & Cardiovascular Systems
Chikashi Nakai, So Izumi, Tomonori Haraguchi, Soichiro Henmi, Shinichi Nakayama, Takahisa Mikami, Takuro Tsukube
Summary: This study analyzed patients with acute type A aortic dissection complicated by malperfusion syndrome to determine the impact of timing of operative treatment and location of malperfusion on outcomes. The study found that conducting surgery within 5 hours of symptom onset significantly improved long-term outcomes for these patients.
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2023)
Article
Surgery
Anastasia Plotkin, Diana Vares-Lum, Gregory A. Magee, Sukgu M. Han, Fernando Fleischman, Vincent L. Rowe
Summary: The study found that in patients with acute aortic dissection complicated with lower extremity malperfusion, resolution of malperfusion was achieved in the majority after aortic repair. Urgent TEVAR for complicated type B and open repair for type A were beneficial. However, patients with limb-first interventions had a higher rate of early delayed failure and required more frequent reoperations.
JOURNAL OF VASCULAR SURGERY
(2021)
Article
Cardiac & Cardiovascular Systems
Shinichi Fukuhara, Elizabeth L. Norton, Neeraj Chaudhary, Nicholas Burris, Suzuna Shiomi, Karen M. Kim, Himanshu J. Patel, G. Michael Deeb, Bo Yang
Summary: Management of type A aortic dissection complicated by cerebral malperfusion presents a challenge. Patients with internal carotid artery (ICA) occlusion have poor outcomes, while those with common carotid artery (CCA) occlusion or comatose state should not be dismissed for surgery. Prompt neck computed tomography angiography in patients with cerebral malperfusion may be necessary.
ANNALS OF THORACIC SURGERY
(2021)
Article
Cardiac & Cardiovascular Systems
Ibrahim Sultan, Valentino Bianco, Himanshu J. Patel, George J. Arnaoutakis, Marco Di Eusanio, Edward P. Chen, Bradley Leshnower, Thoralf M. Sundt, Udo Sechtem, Daniel G. Montgomery, Santi Trimarchi, Kim A. Eagle, Thomas G. Gleason
Summary: Fifteen percent of patients with Type A aortic dissection presented with cerebral malperfusion and neurological deficits. Despite being older and more likely to have peripheral malperfusion, cardiac tamponade, and in shock, nearly 75% of these patients survived in-hospital. Surgeons may continue to offer life-saving surgery for Type A aortic dissection to this critically ill cohort with acceptable morbidity and mortality.
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2021)
Article
Medicine, General & Internal
Thierry Carrel, Thoralf M. Sundt, Yskert von Kodolitsch, Martin Czerny
Summary: Despite advancements in the prevention, diagnosis, and treatment of acute aortic dissection, it remains a complex cardiovascular event with high mortality and morbidity rates. Recent research has improved our understanding of the disease's pathophysiology and led to reevaluations of existing classifications. There is a shift towards a unified naming system based on morphology and function. The location and extent of the initial tear, as well as the affected aortic segments, determine the appropriate management approach - emergency surgery, endovascular intervention, or medical treatment. Ongoing scientific evidence continues to shape the management and follow-up of acute aortic dissection, the most severe form of acute aortic syndrome.
Article
Surgery
Takuya Ogami, George J. Arnaoutakis, Himanshu J. Patel, Chih-Wen Pai, Kim A. Eagle, Santi Trimarchi, Derek Serna-Gallegos, Ibrahim Sultan
Summary: This study aimed to characterize acute kidney injury (AKI) after thoracic endovascular aortic repair (TEVAR) in patients with acute type B aortic dissection (ATBAD). The incidence of postoperative AKI was found to be 16.2% in patients undergoing TEVAR for ATBAD. Patients with postoperative AKI had a higher rate of in-hospital morbidities and mortality than those without AKI. A history of chronic kidney disease (CKD) and preoperative AKI were independently associated with postoperative AKI.
JOURNAL OF VASCULAR SURGERY
(2023)
Article
Emergency Medicine
Yuhei Uriu, Akira Kuriyama
Summary: Acute aortic dissection (AD) is a life-threatening emergency with chest pain as the most common symptom, though rare symptoms like monoplegia can also occur. This study presented a case of transient monoplegia caused by Stanford type-B AD, highlighting the importance of considering AD in patients presenting with monoplegia or other transient symptoms in the emergency department.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2021)
Article
Cardiac & Cardiovascular Systems
Pieter A. J. van Bakel, Matthew Henry, Karen M. Kim, Bo Yang, Joost A. van Herwaarden, C. Alberto Figueroa, Himanshu J. Patel, David M. Williams, Nicholas S. Burris
Summary: This study investigated the association between renal enhancement and renal malperfusion in patients with aortic dissection. The findings suggest that differential enhancement of the kidney on computed tomography angiography can predict the presence of renal malperfusion. However, the diagnosis of renal malperfusion requires close monitoring and often invasive assessment.
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
(2022)
Article
Medical Laboratory Technology
Suwei Chen, Chenhan Zhang, Yongliang Zhong, Bing Tang, Qiang Xie, Rutao Guo, Zhiyu Qiao, Chengnan Li, Yipeng Ge, Junming Zhu
Summary: The study found a correlation between preoperative serum myoglobin concentrations and AKI after TAAD surgery, and high concentrations of serum myoglobin increased the risk of developing any-stage and severe AKI. This finding is significant for the prevention and treatment of AKI after TAAD surgery.
CLINICA CHIMICA ACTA
(2023)