Review
Health Care Sciences & Services
Eduardo Bossone, Andreina Carbone, Kim A. Eagle
Summary: Cardiovascular disease (CVD) is the leading cause of death and morbidity worldwide, and there are differences in the epidemiology and management of CVD between male and female patients. In the case of acute aortic dissection (AAD), women are typically older than men at the time of diagnosis and have a less abrupt onset of pain, leading to delayed presentation to the emergency department. Women also have a higher prevalence of hypertension and chronic obstructive pulmonary disease. In type A AAD, women are more prone to pleural effusion and coronary artery compromise, but experience fewer neurological and malperfusion symptoms. They undergo surgical treatment less frequently and have higher in-hospital mortality rates. In contrast, there are no significant differences in in-hospital mortality between genders in type B AAD. Further studies are needed to develop gender-specific strategies for preventive, diagnostic, and therapeutic approaches to AAD.
JOURNAL OF PERSONALIZED MEDICINE
(2022)
Article
Cardiac & Cardiovascular Systems
Bartosz Rylski, Nikolina Georgieva, Friedhelm Beyersdorf, Christopher Busch, Andreas Boening, Josephina Haunschild, Christian D. Etz, Maximilian Luehr, Klaus Kallenbach
Summary: Acute aortic dissection type A occurs almost twice as frequently in men compared to women. Women with this condition tend to be older, while men are more commonly diagnosed with visceral and renal malperfusion, and receive aortic root replacements more frequently. Despite differences in presentation and treatment, the outcomes of acute aortic dissection type A are similar in both genders.
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2021)
Article
Cardiac & Cardiovascular Systems
Nathan J. Graham, Marc Titsworth, Rana-Armaghan Ahmad, Xiaoting Wu, Aroma Naeem, Karen M. Kim, Shinichi Fukuhara, Himanshu Patel, Michael Deeb, Bo Yang
Summary: There is debate regarding the extent of aortic arch repair for acute type A aortic dissection (ATAAD) patients. This study found that there was no significant difference in long-term survival, distal aorta growth, or reoperation rate for distal aortic aneurysm after hemiarch or zone-specific arch replacement. Therefore, patient-specific arch replacement strategies may be used instead of aggressive arch replacement for all ATAAD patients.
ANNALS OF THORACIC SURGERY
(2023)
Article
Cardiac & Cardiovascular Systems
Yixiao Zhang, Yulin Wang, Jinmiao Chen, Jun Li, Yongxin Sun, Hao Lai, Chunsheng Wang, Qiang Ji
Summary: The association between sex and clinical outcomes after surgical repair of acute type A aortic dissection was studied in this research. The study found that there were no significant differences in terms of in-hospital and midterm outcomes between male and female patients who underwent extended arch repair for ATAAD. However, female patients tended to be older, have a lower body mass index, and were less likely to be current smokers compared to male patients.
CANADIAN JOURNAL OF CARDIOLOGY
(2023)
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
Charles S. Roberts, Carey Camille Roberts, William C. Roberts
Summary: Necropsy findings in 97 patients with acute aortic dissection show that most patients have systemic hypertension, insignificant coronary atherosclerosis, absent myocardial fibrosis, and aortic valve with 3 cusps without stenosis.
AMERICAN JOURNAL OF CARDIOLOGY
(2022)
Article
Cardiac & Cardiovascular Systems
Lauren Huckaby, Ibrahim Sultan, Santi Trimarchi, Bradley Leshnower, Edward P. Chen, Derek R. Brinster, Truls Myrmel, Anthony L. Estrera, Daniel G. Montgomery, Amit Korach, Hans -Henning Eckstein, Joseph S. Coselli, Takeyoshi Ota, Clayton A. Kaiser, Kim A. Eagle, Himanshu J. Patel, Thomas G. Gleason
Summary: In-hospital mortality remains higher among women with TAAD but shows improvement in the last decade. Significant differences in presentation were noted in women, including older age and greater evidence of malperfusion. Although no distinctions in 5-year mortality or reintervention were observed, a tailored surgical approach should be considered to reduce sex disparities in early mortality rates for TAAD.
ANNALS OF THORACIC SURGERY
(2022)
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
Multidisciplinary Sciences
Fang-Ting Chen, An-Hsun Chou, Yi-Hsin Chan, Victor Chien-Chia Wu, Chia-Pin Lin, Kuo-Chun Hung, Pao-Hsien Chu, Yu-Ting Cheng, Shao-Wei Chen
Summary: This study evaluated the sex-related differences in perioperative and late outcomes for adult acute aortic dissection patients. The results showed no significant sex-related difference in in-hospital mortality or accumulative all-cause mortality. However, there were more redo aortic surgeries for males, and more postoperative depression for females.
Article
Biotechnology & Applied Microbiology
Zhenfeng Li, Huanming Xu, Chloe Harriet Armour, Yuze Guo, Jiang Xiong, Xiaoyun Xu, Duanduan Chen
Summary: This study investigated the impact of sealing re-entry tears on the hemodynamics of TBAD. By excluding thoracic re-entries, the study found that sealing them could change the blood flow direction and increase particle residence time in the false lumen. These findings suggest that the hemodynamic status of re-entry tears can serve as an indicator for the necessity of sealing.
FRONTIERS IN BIOENGINEERING AND BIOTECHNOLOGY
(2022)
Article
Surgery
Song Wu, Chenghao Cao, Yu Lun, Han Jiang, Shiyue Wang, Yuchen He, Jianjian Sun, Xin Li, Yuzhen He, Yinde Huang, Wenbin Chen, Shijie Xin, Jian Zhang
Summary: This study investigated the differences in clinical characteristics, treatments, and outcomes of patients with acute aortic dissection (AAD) in different age groups. It found that young patients with AAD had a higher proportion of non-true lumen blood supply, increased visceral and lower limb malperfusion, and an increased risk associated with obesity and an intimal flap that had frequently exceeded the branches of the aorta.
JOURNAL OF VASCULAR SURGERY
(2022)
Article
Medicine, General & Internal
Wael Ahmad, Mark Liebezeit-Sievert, Moritz Wegner, Anastasiia Alokhina, Thorsten Wahlers, Bernhard Dorweiler, Maximilian Luehr
Summary: This study aimed to identify potential endovascular treatment candidates for acute type A aortic dissection (aTAAD) patients through morphological analysis. It found patients eligible for endovascular treatment and provided suggestions for the aortic arch and descending aorta. The results offer valuable insights for implementing endovascular approaches in aTAAD treatment.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Cardiac & Cardiovascular Systems
Jung-Hwan Kim, Seung Hyun Lee, Sak Lee, Young-Nam Youn, Kyung-Jong Yoo, Hyun-Chel Joo
Summary: The study aimed to investigate whether distal aortic maximum false lumen area (MFLA) ratio predicts late aortic dilation and reintervention after open repair of acute type I aortic dissection. The results showed that a high MFLA ratio on the descending thoracic aorta after acute type I aortic dissection repair is associated with increased risk of late aortic reintervention and distal aortic dilation.
ANNALS OF THORACIC SURGERY
(2022)
Article
Cardiac & Cardiovascular Systems
Takeshi Kinoshita, Tohru Asai, Tomoaki Suzuki
Summary: This study measured the outer media thickness (OMT) of the false lumen in patients with DeBakey type I aortic dissection and found that OMT was inversely correlated with the growth rate of the distal dissecting aorta. Patients with OMT of 0.04 to 0.15 mm had a significantly higher risk of aortic-related events.
ANNALS OF THORACIC SURGERY
(2022)
Article
Cardiac & Cardiovascular Systems
Simone Gasser, Lukas Stastny, Markus Kofler, Christoph Krapf, Nikolaos Bonaros, Michael Grimm, Julia Dumfarth
Summary: The study found that female patients with acute aortic dissection type A were older and had a more aggressive and complicated preoperative course. They also had impaired neurological outcomes and lower survival rates.
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
(2022)