Article
Multidisciplinary Sciences
Bo-Cheng Hou, Yu-Tung Huang, Fu-Chih Hsiao, Chien-Chia Wu, Yu-Ting Cheng, Kuo-Sheng Liu, Shang-Hung Chang, Pao-Hsien Chu, An-Hsun Chou, Shao-Wei Chen
Summary: In this study, the learning curve of cardiovascular surgeons in acute type A aortic dissection surgery and the optimal number of procedures for training were explored. The results showed that surgeon experience volume was significantly correlated with in-hospital mortality rate. For surgeons who reached a cumulative volume of 25 acute type A aortic dissection surgeries, the average in-hospital mortality rate of patients could be below 10%. Additionally, the longer duration from the 1st to 25th operations was significantly correlated with a higher average in-hospital mortality rate. In conclusion, there is a prominent learning curve in acute type A aortic dissection surgery, and fostering high-volume surgeons can achieve optimal clinical outcomes.
SCIENTIFIC REPORTS
(2023)
Article
Cardiac & Cardiovascular Systems
Klaus Kallenbach, Christopher Buesch, Bartosz Rylski, Daniel-Sebastian Dohle, Tobias Krueger, Thomas Holubec, Jens Brickwedel, Jochen Poeling, Thilo Noack, Christian Hagl, Philipp Jawny, Andreas Boening, Khaled Chalabi, Matthias Karck, Rawa Arif
Summary: This study aimed to interpret the strategies of aortic root surgery in German AADA patients. The results showed that supracommissural replacement was the preferred surgical method for elderly and compromised patients. Extended root preservation techniques may be used for selected patients, even in combination with extended aortic arch surgery, with promising early outcomes.
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
(2022)
Article
Cardiac & Cardiovascular Systems
Jiade Zhu, Guang Tong, Donglin Zhuang, Yongchao Yang, Zhichao Liang, Yaorong Liu, Changjiang Yu, Zhen Zhang, ZeRui Chen, Jie Liu, Jue Yang, Xin Li, Ruixin Fan, Tucheng Sun, Jinlin Wu
Summary: This study investigated surgical modalities and outcomes in patients with type A aortic dissection involving arch anomalies. By preserving and reconstructing the supra-arch vessels, patients achieved favorable perioperative outcomes. Patients with bovine anomalies had higher perioperative mortality rate and incidence of neurological complications. During the follow-up period, some patients required aortic re-intervention.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Article
Physiology
Zhigang Wang, Jingfang Xu, Xiaofeng Cheng, Lifang Zhang, Dongjin Wang, Jun Pan
Summary: This study aimed to evaluate the clinical significance of postoperative hyperbilirubinemia (PH) after acute type A aortic dissection (ATAAD) surgical repair. The results showed a high incidence of PH, which was associated with worse short- and long-term prognosis. Age, preoperative total bilirubin level, pericardial tamponade, CPB duration, and postoperative CVP level were identified as risk factors for the development of PH.
FRONTIERS IN PHYSIOLOGY
(2022)
Article
Cardiac & Cardiovascular Systems
Kevin R. An, Charles de Mestral, Derrick Y. Tam, Feng Qiu, Maral Ouzounian, Thomas F. Lindsay, Harindra C. Wijeysundera, Jennifer C-Y Chung
Summary: This study found poor adherence to guideline-directed imaging surveillance following ATAAD repair, while long-term mortality and reinterventions rates remained high. Further research is needed to determine if guidelines should be modified.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2021)
Article
Cardiac & Cardiovascular Systems
William C. Roberts, Charles S. Roberts
Summary: The occurrence of acute aortic dissection combined with cardiovascular syphilis is extremely rare, but a recently observed case presented with both conditions. Through operative repair, the entire ascending aorta was examined, revealing classic features of both diseases.
AMERICAN JOURNAL OF CARDIOLOGY
(2022)
Article
Cardiac & Cardiovascular Systems
Leonard Pitts, Roland Heck, Matteo Montagner, Adam Penkalla, Markus Kofler, Volkmar Falk, Joerg Kempfert, Semih Buz
Summary: An individualized endovascular approach may be justified for acute type A aortic dissection in elderly patients with high surgical risk. The use of additional short-length stent graft devices and uncovered stent may enhance the outcomes in treating such cases.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2023)
Article
Multidisciplinary Sciences
Karl C. Koenig, Harald Lahm, Martina Dressen, Stefanie A. Doppler, Stefan Eichhorn, Nicole Beck, Kathrin Kraehschuetz, Sophia Doll, Stefan Holdenrieder, Adnan Kastrati, Ruediger Lange, Markus Krane
Summary: ACAN in plasma samples shows significantly higher levels in ATAAD patients compared to patients with other cardiovascular conditions or healthy volunteers. It may serve as a reliable potential biomarker for detecting ATAAD with high sensitivity and specificity.
SCIENTIFIC REPORTS
(2021)
Article
Cardiac & Cardiovascular Systems
Kyokun Uehara, Hitoshi Matsuda, Jiro Matsuo, Yosuke Inoue, Takayuki Shijo, Atsushi Omura, Yoshimasa Seike, Hiroaki Sasaki, Junjiro Kobayashi
Summary: This study evaluated outcomes of acute type A aortic dissection (AAAD) patients who required cardiopulmonary resuscitation (CPR), finding that CPR duration beyond 15 minutes may be a contraindication for AAAD repair. Achieving return of spontaneous circulation before surgery was a significant factor in better prognosis. These findings can help guide clinical decision-making and improve survival rates for AAAD patients.
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2021)
Article
Cardiac & Cardiovascular Systems
Vincenzo Vento, Sebastien Multon, Ramzi Ramadan, Philippe Deleuze, Dominique Fabre, Julien Guihaire, Stephan Haulon
Summary: Ascending aorta wrapping is associated with favorable early outcomes and a low rate of aortic events during follow-up. This therapeutic option should be considered for patients considered too fragile for standard surgical repair.
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2022)
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
Cardiac & Cardiovascular Systems
Umberto Benedetto, Arnaldo Dimagli, Amit Kaura, Shubhra Sinha, Giovanni Mariscalco, George Krasopoulos, Narain Moorjani, Mark Field, Trivedi Uday, Simon Kendal, Graham Cooper, Rakesh Uppal, Haris Bilal, Jorge Mascaro, Andrew Goodwin, Gianni Angelini, Geoffry Tsang, Enoch Akowuah
Summary: This study aimed to investigate the relationship between surgical outcomes of TAAAD patients in the UK and variables including patient characteristics, intraoperative factors, cardiac centers, and surgeons. The study found significant associations between age, malperfusion, left ventricular ejection fraction, previous cardiac surgery, preoperative mechanical ventilation, preoperative resuscitation, concomitant coronary artery bypass grafting, and surgical outcomes. Additionally, there was an inverse relationship between surgeon annual volume and outcomes.
EUROPEAN HEART JOURNAL
(2022)
Article
Medicine, General & Internal
Fausto Biancari, Matteo Pettinari, Giovanni Mariscalco, Caius Mustonen, Francesco Nappi, Joscha Buech, Christian Hagl, Antonio Fiore, Joseph Touma, Angelo M. Dell'Aquila, Konrad Wisniewski, Andreas Rukosujew, Andrea Perrotti, Amelie Herve, Till Demal, Lenard Conradi, Marek Pol, Petr Kacer, Francesco Onorati, Cecilia Rossetti, Igor Vendramin, Daniela Piani, Mauro Rinaldi, Luisa Ferrante, Eduard Quintana, Robert Pruna-Guillen, Javier Rodriguez Lega, Angel G. Pinto, Timo Makikallio, Metesh Acharya, Zein El-Dean, Mark Field, Amer Harky, Sebastien Gerelli, Dario Di Perna, Mikko Jormalainen, Giuseppe Gatti, Enzo Mazzaro, Tatu Juvonen, Sven Peterss
Summary: This study found that iatrogenic acute Stanford type A aortic dissection (TAAD), although uncommon, carries a significantly higher risk of in-hospital mortality compared to spontaneous TAAD. The 5-year mortality is comparable between different subgroups of iatrogenic TAAD.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Surgery
Wei Qin, Rui Fan, Jiankai Wang, Jian Li, Fuhua Huang, Xin Chen
Summary: This study evaluated the operative and long-term outcomes of Type A AAD patients who received aortic dissection repair plus CABG or local coronary repair. The study found that the effects on perioperative results and long-term survival for patients with CA involvement were equal between the two surgery strategies.
FRONTIERS IN SURGERY
(2022)
Article
Cardiac & Cardiovascular Systems
Yoshihiro Suematsu, Takafumi Inoue, Satoshi Nishi, Kanan Kurahashi, Akihiro Yoshimoto
Summary: A new surgical approach using artificial grafts (stepwise external wrapping) showed excellent outcomes for high-risk patients with type A acute aortic dissection, with low inhospital mortality and high survival rates during follow-up.
ANNALS OF THORACIC SURGERY
(2023)