A systematic review and meta-analysis of the incidence of acute aortic dissections in population-based studies

Melo, Ryan Gouveia e; Mourão, Mariana Alves; Caldeira, Daniel; Alves, Mariana; Lopes, Alice; Duarte, Antonio Moral; Fernandes, Ruy Fernandes e; Pedro, Luís Mendes

doi:10.1016/j.jvs.2021.08.080

Cited by 45 publications

(24 citation statements)

References 46 publications

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“…TAA, though uncommon, is a life-threatening condition given the increased risk of rupture 4 , 5 . We presented an unusual case of a 33-year-old female who was evaluated for new onset hemoptysis in the context of a subacute cough.…”

Section: Discussionmentioning

confidence: 99%

Thoracic Aortic Aneurysm Presenting as a Subacute Cough

Diaz

Atia

Kohen

et al. 2023

pocus

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The suprasternal aortic notch cardiac point of care ultrasound (POCUS) window is a useful view for evaluating thoracic aortic pathologies. However, it is not routinely included in the standard cardiac POCUS exam despite its ability to capture emergent pathologies such as aortic dissection and thoracic aortic aneurysm (TAA). Ruptured aortic aneurysms can present with sudden, severe chest or back pain, as well as hemodynamic instability, resulting in a high mortality. We present an atypical case of a patient with hemoptysis who was found to have a contained aortic rupture. In this case, POCUS, specifically the suprasternal aortic notch view, was used to expedite definitive care.

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Section: Discussionmentioning

confidence: 99%

Thoracic Aortic Aneurysm Presenting as a Subacute Cough

Diaz

Atia

Kohen

et al. 2023

pocus

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“…Acute aortic dissection (AAD) accounts for the majority of AAS cases [3,7]. A recent meta-analysis of 33 population studies estimated the pooled incidence at 4.8 per 100 000/year [8]. Nonetheless, true incidence of aortic dissection is still likely underestimated because of significant rates of out-ofhospital and early mortality, which may be misdiagnosed or misclassified [9,10].…”

Section: Differences In Incidence and Age Of Presentationmentioning

confidence: 99%

Gender differences in acute aortic syndromes

Bhatt

Chung

2023

Current Opinion in Cardiology

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Purpose of reviewAcute aortic syndromes include acute aortic dissection, intramural hematoma, and penetrating aortic ulcer, and are associated with high mortality and morbidity. This review focuses on recent findings and current understanding of gender-related and sex-related differences in acute aortic syndromes. Recent findingsLarge international and national registries, population studies, and multicentre national prospective cohort studies show evidence of sex differences in acute aortic syndromes. Recent studies of risk factors, aorta remodelling, and genetics provide possible biological basis for sex differences. The 2022 American College of Cardiology/American Heart Association Guidelines for the Diagnosis and Management of Aortic Disease revise recommendations for surgical management for aortic root and ascending aorta dilatation, which could impact outcome differences between the sexes.

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“…Acute type A aortic dissection is an uncommon disease with an incidence of 3.0 per 100,000/year [ 1 ]. However, it is a life-threatening disease with a mortality rate that increases 1–2% per hour within the initial 48 h [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

Reintervention of Residual Aortic Dissection after Type A Aortic Repair: Results of a Prospective Follow-Up at 5 Years

Porto

Omnès

Bartoli

et al. 2023

JCM

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Background After a type A aortic dissection repair, a patent false lumen in the descending aorta is the most common situation encountered, and is a well-known risk factor for aortic growth, reinterventions and mortality. The aim of this study was to analyze the long-term results of residual aortic dissection (RAD) at a high-volume aortic center with prospective follow-up. Methods In this prospective single-center study, all patients operated for type A aortic dissection between January 2017 and December 2022 were included. Patients without postoperative computed tomography scans or during follow-up at our center, and patients without RAD were excluded. The primary endpoint was all-cause mortality during follow-up for patients with RAD. The secondary endpoints were perioperative mortality, rate of distal aneurysmal evolution, location of distal aneurysmal evolution, rate of distal reinterventions, outcomes of distal reinterventions, and aortic-related death during follow-up. Results In total, 200 survivors of RAD comprised the study group. After a mean follow-up of 27.2 months (1–66), eight patients (4.0%) died and 107 (53.5%) had an aneurysmal progression. The rate of distal reintervention was 19.5% (39/200), for malperfusion syndrome in seven cases (3.5%) and aneurysmal evolution in 32 cases (16.0%). Most reinterventions occurred during the first 2 years (82.1%). Twenty-seven patients were treated for an aneurysmal evolution of RAD including aortic arch with hybrid repair in 21 cases and branched aortic arch endoprosthesis in six cases. In the hybrid repair group, there was no death, and the rate of morbidity was 28.6% (6/21) (one minor stroke, one pulmonary complication, one recurrent paralysis with complete recovery and three major bleeding events). In the branched endograft group, there was no death, no stroke, and no paraplegia. There was one case (16.7%) of carotid dissection. Complete aortic remodeling or complete FL thrombosis on the thoracic aorta was found in 18 cases (85.7%) and in five cases (83.3%) in the hybrid and branched endograft groups, respectively. Conclusions: Despite a critical course in most cases of RAD, with a high rate of aneurysmal evolution and reintervention, the long-term mortality rate remains low with a close follow-up and a multidisciplinary management in an expert center.

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A systematic review and meta-analysis of the incidence of acute aortic dissections in population-based studies

Cited by 45 publications

References 46 publications

Thoracic Aortic Aneurysm Presenting as a Subacute Cough

Thoracic Aortic Aneurysm Presenting as a Subacute Cough

Gender differences in acute aortic syndromes

Reintervention of Residual Aortic Dissection after Type A Aortic Repair: Results of a Prospective Follow-Up at 5 Years

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