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Seminars in Thoracic and Cardiovascular... 2021
Topics: Aortic Dissection; COVID-19; China; Humans; Pandemics; SARS-CoV-2; United States
PubMed: 33607261
DOI: 10.1053/j.semtcvs.2021.01.025 -
Interactive Cardiovascular and Thoracic... Jul 2022Presentation, management and outcomes in the aortic dissection (AD) of ascending thoracic aortic aneurysm (ATAA) differ in gender and age. The purpose of this study is...
OBJECTIVES
Presentation, management and outcomes in the aortic dissection (AD) of ascending thoracic aortic aneurysm (ATAA) differ in gender and age. The purpose of this study is to investigate the dissection properties of male and female ATAAs.
METHODS
Peeling tests were performed to quantitatively determine the delamination strength and dissection energy of 41 fresh ATAA samples (22 males and 19 females) in relatively young (≤65 years) and elderly (>65 years) patients. The delamination strength of the ATAAs was further correlated with patient ages for males and females. The histological investigation was employed to characterize the dissected morphology.
RESULTS
For elderly patients, circumferential and longitudinal delamination strengths of the female ATAAs were statistically significantly lower than those of the males (circumferential: 31 ± 6 vs 42 ± 6 mN/mm, P < 0.01; longitudinal: 35 ± 7 vs 49 ± 10 mN/mm, P = 0.02). No significant differences were found in the delamination strength between males and females for relatively young patients. The circumferential and longitudinal delamination strengths were significantly decreased and strongly correlated with patient ages for females. However, these correlations were not present in males. Dissection routes propagated in the aortic media to create ruptured surfaces for all specimens. Peeling tests of the male ATAAs generate rougher surfaces than females.
CONCLUSIONS
There is a higher propensity of AD occurrence for the elderly females as compared to males with matched ages. Surgeons should be cognizant of the risk of AD onset later in life, especially in females.
Topics: Aged; Aortic Dissection; Aorta; Aortic Aneurysm; Aortic Aneurysm, Thoracic; Biomechanical Phenomena; Female; Humans; Male; Sex Factors
PubMed: 35285896
DOI: 10.1093/icvts/ivac068 -
Current Problems in Surgery Mar 2017
Review
Topics: Aortic Dissection; Aorta; Aortic Aneurysm; Genetic Predisposition to Disease; Humans; Risk Factors
PubMed: 28521856
DOI: 10.1067/j.cpsurg.2017.01.001 -
Current Problems in Cardiology Oct 2010Abdominal aortic aneurysm (AAA) remains an important cause of morbidity and mortality in elderly men, and prevalence is predicted to increase in parallel with a global... (Review)
Review
Abdominal aortic aneurysm (AAA) remains an important cause of morbidity and mortality in elderly men, and prevalence is predicted to increase in parallel with a global aging population. AAA is commonly asymptomatic, and in the absence of routine screening, diagnosis is usually incidental when imaging to assess unrelated medical complaints. In the absence of approved diagnostic and prognostic markers, AAAs are monitored conservatively via medical imaging until aortic diameter approaches 50-55 mm and surgical repair is performed. There is currently significant interest in identifying molecular markers of diagnostic and prognostic value for AAA. Here we outline the current guidelines for AAA management and discuss modern scientific techniques currently employed to identify improved diagnostic and prognostic markers.
Topics: Aortic Dissection; Aortic Aneurysm, Abdominal; Diagnosis, Differential; Genetic Markers; Genomics; Humans; Postoperative Period; Prognosis; Risk Factors; Tomography, X-Ray Computed; United States
PubMed: 20932435
DOI: 10.1016/j.cpcardiol.2010.08.004 -
The Journal of Thoracic and... Aug 2021
Topics: Aortic Dissection; Humans
PubMed: 32381332
DOI: 10.1016/j.jtcvs.2020.03.068 -
The Journal of Thoracic and... Mar 2022
Topics: Aortic Dissection; Aorta; Humans
PubMed: 32507304
DOI: 10.1016/j.jtcvs.2020.04.061 -
Neurology India 2018
Review
Topics: Aortic Dissection; Humans; Intracranial Aneurysm
PubMed: 29322954
DOI: 10.4103/0028-3886.222834 -
Seminars in Thoracic and Cardiovascular... 2022Our aim was to analyze outcomes of patients aged 70 years or above presenting with type A acute aortic dissection (TAAAD) and cerebrovascular accident (CVA). A...
Our aim was to analyze outcomes of patients aged 70 years or above presenting with type A acute aortic dissection (TAAAD) and cerebrovascular accident (CVA). A retrospective analysis of the International Registry of Acute Aortic Dissection (IRAD) was conducted. Patients aged 70 years or above (n = 1449) were stratified according to presence or absence of CVA before surgery (CVA: n = 110, 7.6%). In-hospital outcomes and mortality up to 5 years were analyzed. Additionally, in-hospital outcomes of patients who received medical management were described. No patient presenting with CVA over the age of 87 years underwent surgery. The rates of in-hospital mortality and post-operative CVA were significantly higher in patients presenting with CVA (in-hospital mortality: 32.7% vs 21.7%, P = 0.008; post-operative CVA: 23.4% vs 8.3%, P < 0.001). Presence of CVA was independently associated with significantly increased in-hospital mortality (odds ratio 2.99, 95% confidence interval 1.35 - 6.60, P = 0.007). In survivors of the hospital stay, presenting CVA had no independent influence on mortality up to 5 years (hazard ratio 1.52, 95% confidence interval 0.99 - 2.31, P = 0.54). In medically managed patients, exceedingly high rates of in-hospital mortality (71.4%) and CVA (90.9%) were noted. Patients presenting with TAAAD and CVA at ≥ 70 years of age are at significantly increased risk of in-hospital mortality, although long-term mortality is not affected in hospital survivors. Medical management is associated with poor outcomes. We believe that surgical management should be offered after critical assessment of comorbidities.
Topics: Acute Disease; Aged; Aortic Dissection; Hospital Mortality; Humans; Registries; Retrospective Studies; Risk Factors; Stroke; Treatment Outcome
PubMed: 34146671
DOI: 10.1053/j.semtcvs.2021.06.008 -
Heart (British Cardiac Society) Feb 2007
Review
Topics: Adult; Aortic Dissection; Antihypertensive Agents; Aortic Aneurysm; Echocardiography, Transesophageal; Emergencies; Humans; Middle Aged; Stents; Tomography, X-Ray Computed
PubMed: 17228080
DOI: 10.1136/hrt.2005.078550 -
BMJ Case Reports Jul 2019Acute aortic dissection presenting neurological symptoms is rare and entails significant diagnostic challenges. We present a case of 45-year-old woman with a medical...
Acute aortic dissection presenting neurological symptoms is rare and entails significant diagnostic challenges. We present a case of 45-year-old woman with a medical history of essential hypertension and smoking, admitted with lobar pneumonia. During her inpatient treatment, she developed severe back pain and numbness below the level of the umbilicus. Due to her presenting symptoms considered differential diagnoses were paravertebral abscess and acute stroke. CT scan of the head did not reveal any ischaemic changes. Further investigation with MRI (with and without contrast) raised concerns for possible aortic dissection. CT angiography of thorax, abdomen and pelvis displayed extensive aortic dissection extending from aortic root to left iliac artery limiting flow to right carotid artery causing stenosis. The patient was diagnosed with Stanford type A aortic dissection. The patient was referred to the cardiothoracic surgery team for surgical repair. The patient made a good recovery after a prolonged course of hospitalisation, followed by cardiac rehabilitation and physical therapy.
Topics: Acute Disease; Aortic Dissection; Aorta; Carotid Arteries; Computed Tomography Angiography; Constriction, Pathologic; Diagnosis, Differential; Female; Humans; Iliac Artery; Magnetic Resonance Imaging; Middle Aged; Paraplegia; Treatment Outcome
PubMed: 31289149
DOI: 10.1136/bcr-2019-230561