Acute aortic dissection and medial degeneration in patients with 'floppy' mitral valves.

McKay, Roxane; Yacoub, Magdi H.

doi:10.1136/thx.31.1.49

Cited by 10 publications

(1 citation statement)

References 16 publications

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“…4 Meanwhile, in the patients with medial necrosis of the ascending aorta, mitral regurgitation was frequent and mucoid degeneration of the mitral leaflet and core disruption of the mitral chord have been found. 12 Transthoracic echocardiography is valuable in verifying aortic dissection of the proximal ascending aorta better than of the distal ascending, transverse, and descending aorta, and it is plausible for the diagnosis of type A dissection in patients with shock. In contrast, TEE is specific in viewing the entire thoracic aorta for aortic dissection.…”

Section: Discussionmentioning

confidence: 99%

Echocardiographic Delineation of Type a Aortic Dissection

Yuan¹,

Lavee

Kuperstein

2012

Hong Kong j. emerg. med.

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Introduction In addition to proving the visualisation data, studies on the intimal flaps of aortic dissection based on echocardiography have been very limited. Methods Twenty-seven patients undergoing an operation of type A aortic dissection with preoperative transthoracic and/or intraoperative transesophageal echocardiography archived in the Horizon Cardiology Web of the hospital available for review and measurement were selected into this retrospective study. By way of quantitative and qualitative approaches, flap movement, dissection extent and aortic obstruction were sufficiently evaluated. Results An intimal flap was visualised in 22 (81.5%) patients and linear artifact was viewed in 1 (3.7%), and in the remaining 4 (14.8%), neither an intimal flap nor a linear artifact was visible. Dissection extents were 2.78±1.53 cm and 2.03±1.19 cm in the horizontal and vertical direction, respectively. Sub- or semi-circumferential dissection was noted in 14 (51.8%) patients. No total circumferential dissection was found in this patient population with type A aortic dissection. The obstruction of the aortic valve orifice or aortic cavity developed in 11 (40.7%) patients. Flow disturbance and thrombus in the false lumen were visualised in 24 (88.9%) and 4 (14.8%) patients, respectively. The breadth of flap movement in short-axis plane was much larger in the Aortic Obstruction Group than that of the Non-Obstruction Group (1.55±1.14 cm vs. 0.75±0.526 cm, p <0.05). Conclusions Preoperative transthoracic or transesophageal echocardiographic evaluations offer a convenient and precise diagnostic tool for aortic dissection. The dissection extent may directly correlate and substantially reflect the clinical symptoms of the patients with type A aortic dissection in response to the haemodynamic impairment. Preoperative echocardiographic delineation would assure adequate means and extent of the impending operation.

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Section: Discussionmentioning

confidence: 99%