Aortic Dissection and Sudden Unexpected Deaths: A Retrospective Study of 31 Forensic Autopsy Cases

Li, Yang; L, Li; Mu, Hong-Shu; Fan, Shuanliang; He, Fanggang; Wang, Zhenyuan

doi:10.1111/1556-4029.12768

Cited by 20 publications

(12 citation statements)

References 39 publications

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“…In ATAAD patients, aortic rupture with massive bleeding leading to cardiac tamponade and/or exsanguination is the most common cause of mortality before the patient reaches hospital [104,105]. For those who reach hospital alive, important prognostic factors for 30-day and late mortality are shown in Table 3.…”

Section: Outcome and Long-term Follow-upmentioning

confidence: 99%

Acute type A aortic dissection – a review

Guðbjartsson

Ahlsson

Geirsson

et al. 2019

Scandinavian Cardiovascular Journal

107

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Acute type A aortic dissection (ATAAD) is still one of the most challenging diseases that cardiac surgeons encounter. This review is based on the current literature and includes the results from the Nordic Consortium for Acute Type-A Aortic Dissection (NORCAAD) database. It covers different aspects of ATAAD and concentrates on the outcome of surgical repair. The diagnosis is occasionally delayed, and ATAAD is usually lethal if prompt repair is not performed. The dynamic nature of the disease, the variation in presentation and clinical course, and the urgency of treatment require significant attentiveness. Many surgical techniques and perfusion strategies of varying complexity have been described, ranging from simple interposition graft to total arch replacement with frozen elephant trunk and valve-sparing root reconstruction. Although more complex techniques may provide long-term benefit in selected patients, they require significant surgical expertise and experience. Short-term survival is first priority so an expedited operation that fits in with the surgeon's level of expertise is in most cases appropriate. ARTICLE HISTORY Definitions and classification systemsDissection of the aorta occurs when the aortic media is separated, usually by pulsatile flow that penetrates the intimal layer of the aortic wall [14] (Figure 1(b)). This allows blood to flow between the layers of the aortic wall, forcing the layers apart, creating a false lumen parallel to the native (i.e. true) aortic lumen (Figure 1(b)). Consequently, the false lumen can propagate in both directions from the tear of intima and affect most of its distal branches, including the coronary, cerebral, and mesenteric arteries [15]. Another-but less common-CONTACT Tomas Gudbjartsson

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Section: Outcome and Long-term Follow-upmentioning

confidence: 99%

Acute type A aortic dissection – a review

Guðbjartsson

Ahlsson

Geirsson

et al. 2019

Scandinavian Cardiovascular Journal

107

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“…The patient however, did not have any history of cardiovascular illnesses. Chest radiography and electrocardiography can give the first clues to diagnose AAD, but they have a low sensitivity and specificity . Multiple studies have suggested D‐Dimer should be used as a positive biomarker in diagnosing AAD .…”

Section: Discussionmentioning

confidence: 99%

Acute aortic dissection mimicking a gastric ulcer: Medico‐legal implications

Mesrati¹,

Boussaïd²,

Abdejlil

et al. 2019

Clinical Case Reports

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“…A retrospective study by Li et al examining the forensic characteristics of patients who suffered sudden unexpected deaths due to an aortic dissection showed that 83.9% of the patients were misdiagnosed and the dissection was not recognized. Of these, only one case was diagnosed as acute pancreatitis, which highlights the rarity of this presentation [ 5 ]. To our knowledge, there are only ten well-documented cases reported worldwide.…”

Section: Discussionmentioning

confidence: 99%

Aortic Dissection Presenting as Acute Pancreatitis: Suspecting the Unexpected

Hafeez

Karmo

Mercado-Alamo

et al. 2018

Case Reports in Cardiology

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Aortic dissection is a life-threatening condition in which the inner layer of the aorta tears. Blood surges through the tear, causing the inner and middle layers of the aorta to separate (dissect). It is considered a medical emergency. We report a case of a healthy 56-year-old male who presented to the emergency room with sudden onset of epigastric pain radiating to his back. His blood pressure was 167/91 mmHg, equal in both arms. His lipase was elevated at 1258 U/L, and he was clinically diagnosed with acute pancreatitis (AP). He denied any alcohol consumption, had no evidence for gallstones, and had normal triglyceride level. Two days later, he endorsed new suprapubic tenderness radiating to his scrotum, along with worsening epigastric pain. A MRCP demonstrated evidence of an aortic dissection (AD). CT angiography demonstrated a Stanford type B AD extending into the proximal common iliac arteries. His aortic dissection was managed medically with rapid blood pressure control. The patient had excellent recovery and was discharged home without any surgical intervention.

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Aortic Dissection and Sudden Unexpected Deaths: A Retrospective Study of 31 Forensic Autopsy Cases

Cited by 20 publications

References 39 publications

Acute type A aortic dissection – a review

Acute type A aortic dissection – a review

Acute aortic dissection mimicking a gastric ulcer: Medico‐legal implications

Aortic Dissection Presenting as Acute Pancreatitis: Suspecting the Unexpected

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