The acute aortic syndromes (AAS) are life-threatening vascular compromises within the aortic wall. These include aortic dissection (AD), intramural hematoma (IMH), penetrating aortic ulcer (PAU), and blunt traumatic thoracic aortic injury (BTTAI). While patients classically present with chest pain, the presentation may be highly variable. Timely diagnosis is critical to initiate definitive treatment and maximize chances of survival. In high-risk patients, treatment should begin immediately, even while diagnostic evaluation proceeds. The mainstay of medical therapy is acute reduction of heart rate and blood pressure. Surgical intervention is often required but is informed by patient anatomy and extent of vascular compromise.
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Number and mortality of aortic surgery in Japan.
Nagoya J Med Sci
November 2024
Cardiovascular Surgery, Fujita Health University Okazaki Medical Center, Okazaki, Japan.
According to the Japanese Association for Thoracic Surgery annual surgery survey, the number of aortic surgery has been increasing constantly in the last two decades, with the rates approximately doubling in each decade (5,167, 11,956, and 22,708 cases in 1999, 2009, and 2019, respectively). In 2019, aortic surgery was performed for 11,036 (49%) nondissecting unruptured aneurysm, 730 (3%) ruptured aneurysm, 6,351 (28%) acute type A aortic dissection, 1,412 (6%) chronic type A aortic dissection, 2,385 (11%) acute type B aortic dissection, and 703 (3%) chronic type B aortic dissection cases. The outcomes have been improving annually.
View Article and Find Full Text PDFThe relationship of sex and aortic diameter at the time of acute type A aortic dissection.
JTCVS Open
December 2024
Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY.
Objective: Evaluate sex differences in patients undergoing repair of acute type A aortic dissection (ATAAD).
Methods: Sex-stratified, single-center cohort study of patients undergoing ATAAD repair from 1997 to 2022. The primary outcome was aortic diameter at time of presentation with ATAAD.
Interatrial block is an independent risk factor for new-onset atrial fibrillation after cardiac surgery.
JTCVS Open
December 2024
Department of Cardiac Surgery, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany.
Objectives: This study aims to investigate the association between interatrial conduction block and postoperative atrial fibrillation, which can precipitate acute cardiopulmonary instability and is associated with subsequent heart failure, stroke, and mortality following cardiac surgery.
Methods: Perioperative 12-channel electrocardiograms from 3405 patients undergoing myocardial revascularization, valve surgery, aortic surgery, or combinations thereof, were considered. Clinical and electrographic parameters were compared between patients with and without atrial fibrillation, and significant variables were analyzed using univariate and multivariate logistic regression.
Three-dimensional morphometry of the human thoracic aorta using centerline analysis based on least-squares plane fitting.
JTCVS Open
December 2024
Department of Cardiovascular Surgery, Seirei Mikatahara General Hospital, Hamamatsu, Japan.
Objective: A novel approach to 3-dimensional morphometry of the thoracic aorta was developed by applying centerline analysis based on least-squares plane fitting, and a preliminary study was conducted using computed tomography imaging data.
Methods: We retrospectively compared 3 groups of patients (16 controls without aortic disease, and 16 cases each with acute type B aortic dissection and congenital bicuspid aortic valve). In addition to the standard assessment indices for curvature κ and torsion τ, we conducted coordinate transformation based on the least-squares plane, divided the centerline into 3 representative features (transverse, anterior-posterior, and longitudinal displacements), and analyzed the overall and local displacement in each direction.
Aortic lumen repair with glue-felt technique before proximal anastomosis in acute type a aortic dissection surgery.
J Cardiothorac Surg
January 2025
Cerrahpasa Medical Faculty, Department of Cardiovascular Surgery, Istanbul University-Cerrahpasa, Istanbul, Turkey.
Objectives: Despite the advances in medicine, aortic dissection remains a cardiac surgery emergency with high mortality and morbidity rates. This study examined the effects of the Glue + Felt technique, which uses biological glue and felt to repair the proximal anastomotic site, on the outcomes of patients with acute type A aortic dissection.
Methods: A total of 108 patients who underwent surgery for acute type A aortic dissection at our clinic between 2007 and 2020 were included in the study.
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