Objective: Aortic dissection remains a life-threatening condition necessitating accurate diagnosis and timely intervention. This study aimed to investigate phenotypic heterogeneity in patients with Stanford type B aortic dissection (TBAD) through machine learning clustering analysis of cardiovascular computed tomography (CT) imaging.
Methods: Electronic medical records were collected to extract demographic and clinical features of patients with TBAD. Exclusion criteria ensured homogeneity and clinical relevance of the TBAD cohort. Controls were selected on the basis of age, comorbidity status, and imaging availability. Aortic morphological parameters were extracted from CT angiography and subjected to K-means clustering analysis to identify distinct phenotypes.
Results: Clustering analysis revealed three phenotypes of patients with TBAD with significant correlations with population characteristics and dissection rates. This pioneering study used CT-based three-dimensional reconstruction to classify high-risk individuals, demonstrating the potential of machine learning in enhancing diagnostic accuracy and personalized treatment strategies. Recent advancements in machine learning have garnered attention in cardiovascular imaging, particularly in aortic dissection research. These studies leverage various imaging modalities to extract valuable features and information from cardiovascular images, paving the way for more personalized interventions.
Conclusion: This study provides insights into the phenotypic heterogeneity of patients with TBAD using machine learning clustering analysis of cardiovascular CT imaging. The identified phenotypes exhibit correlations with population characteristics and dissection rates, highlighting the potential of machine learning in risk stratification and personalized management of aortic dissection. Further research in this field holds promise for improving diagnostic accuracy and treatment outcomes in patients with aortic dissection.
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http://dx.doi.org/10.1016/j.hjc.2024.08.006 | DOI Listing |
Cardiovasc Interv Ther
January 2025
Division of Cardiology, Department of Medicine, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osakasayama, Osaka, 589-8511, Japan.
Transcatheter aortic valve implantation (TAVI) using the NAVITOR system has been relatively underreported due to its recent introduction in Japan. This study aimed to assess the short-term outcomes of TAVI with the NAVITOR in real-world clinical practice. Patients with severe aortic stenosis who underwent TAVI using the NAVITOR system at our institution between December 2022 and December 2023 were prospectively enrolled.
View Article and Find Full Text PDFAnn Thorac Surg
January 2025
Center for Cardiac Surgical Intensive Care, Beijing Anzhen Hospital, Capital Medical University, Beijing, China; Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China. Electronic address:
Background: We seek to study whether early initiation of renal replacement therapy (RRT) could reduce 90-day mortality and improve clinical outcomes in patients with acute kidney injury following acute type A aortic dissection.
Methods: This is a single-center, randomized, controlled trial that enrolled acute type A aortic dissection patients with severe post-operative acute kidney injury (Kidney Disease: Improving Global Outcomes (KDIGO) stage 2) and with plasma neutrophil gelatinase-associated lipocalin level > 150 ng/mL who did not have potentially life-threatening complications directly related to renal failure. Patients were randomized equally into two groups: the early RRT group received RRT within 6 hours of diagnosis of KDIGO stage 2; the standard treatment group was managed with RRT initiated within 8 hours of stage 3.
Vascular
January 2025
Department of Surgery, Division of Vascular and Endovascular Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Objectives: We aim to evaluate the safety and effectiveness of the Zenith Dissection Endovascular System (ZDES; Zenith TX2 Dissection Endovascular Graft with Pro-Form and Zenith Dissection Endovascular Stent), which uses a proximal stent graft along with a distal bare metal stent compared to traditional stent grafts in the repair of acute, complicated Type B Aortic Dissection (AcTBAD).
Methods: This retrospective study reviews the medical charts of 32 patients with AcTBAD repaired at a single urban academic medical center. 16 of these AcTBAD cases were repaired with the ZDES (87.
J Vasc Surg Cases Innov Tech
February 2025
Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at UTHealth Houston, Houston, TX.
Heritable thoracic aortic disease is caused by dominantly inherited mutations in more than a dozen genes, including mutations that cause Loeys-Dietz syndrome. McGovern Medical School at UTHealth Houston convenes a regular conference that includes cardiothoracic and vascular surgeons, cardiologists, geneticists, radiologists, and pathologists to formulate multidisciplinary approaches for the management of complex heritable thoracic aortic disease cases. In this report, we highlight the unique management of individuals with distinct presentations of Loeys-Dietz syndrome owing to mutations.
View Article and Find Full Text PDFFront Cardiovasc Med
December 2024
Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
Background: Acute type A aortic dissection (ATAAD) poses significant challenges in cardiovascular management due to its high morbidity and mortality rates. Postcardiotomy cardiogenic shock (PCS) is a severe complication following ATAAD repair that complicates postoperative recovery. Extracorporeal membrane oxygenation (ECMO) has emerged as a potential life-saving intervention in this context, yet the specific outcomes related to ECMO in ATAAD patients remain insufficiently studied.
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