Acute Aortic Dissection in Young Adult Patients: Clinical Characteristics, Management, and Perioperative Outcomes.

J Invest Surg

Department of Cardiovascular Surgery, Beijing Anzhen Hospital of Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, and Beijing Engineering Research Center of Vascular Prostheses, Beijing, China.

Published: March 2020

AI Article Synopsis

  • Acute aorta dissection (AD) is a serious emergency affecting mostly young adults under 45, with a study of 490 patients in China showing a median age of 38, predominantly young men, and high rates of smoking and hypertension.
  • The most common symptom was sudden chest or back pain, and the majority of patients underwent surgical treatment, though a small number experienced serious complications during the perioperative period.
  • The study found that longer cardiopulmonary bypass times and a history of previous heart surgeries were linked to higher rates of surgery-related complications and mortality, highlighting the importance of these factors in managing acute AD.

Article Abstract

Acute aorta dissection (AD) is a fatal emergency, however, studies addressing the clinical characteristics, management, and outcome of acute AD in young adult patients aged under 45 years in China are very few. A retrospective study including 490 patients with acute AD as the final diagnosis was conducted. Patients' demographics, clinical characteristics, medical history, and laboratory and diagnostic imaging findings were retrieved from medical records. The median age of young adult patients with acute AD was 38 years old with an interquartile range from 33 to 41. Male and smoker constituted 84.49% and 50.61% of the cohort, respectively. Hypertension was found in 54.49%, while Marfan syndrome was seen in 4.29% of the patients. Abrupt onset of chest or back pain was the most common symptoms (85.31%), while altered consciousness, coma and oliguria were less reported. Most patients (89.39%) were managed with surgical interventions. Typical complications (central nervous system complications, spinal cord ischemia, myocardial ischemia/infarction, mesenteric ischemia/infarction and acute renal failure) were seen in a small portion of treated patients during perioperative period. For in-hospital mortality there were 24 (∼5%) cases recorded. Correlation analysis indicated that perioperative complications were associated with the length of cardiopulmonary bypass (CPB) ( < 0.0001), and mortality after surgery correlated history of prior cardiac surgery ( = 0.043). CPB and prior cardiac surgery were associated with perioperative complications and mortality after surgery, respectively. The findings are valuable to the further refinement of diagnosis and surgical management of patients with acute aortic dissection.

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Source
http://dx.doi.org/10.1080/08941939.2018.1489916DOI Listing

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