Cluster analysis of acute ascending aortic dissection provides novel insight into mechanisms of distal progression

Philip, Jennifer L.; Oliveira, Nilto C. De; Akhter, Shahab A.; Rademacher, Brooks L.; Goodavish, Christopher B.; DiMusto, Paul D.; Tang, Paul C.

doi:10.21037/jtd.2017.08.06

Cited by 5 publications

(2 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Accordingly, DeBakey type II and false lumen thrombosis were more frequently observed in the high-score group than in the low-score group. DeBakey type II dissections were correlated with atherosclerotic disease, and the prevalence of distally extended aortic dissection was lower in patients with non-communicating false lumens than in those with patent false lumens, which are consistent with the results of previous studies [34,35]. Furthermore, there is a greater decrease in false lumen pressure in aortic dissection with a thrombosed false lumen compared with a patent false lumen [36].…”

Section: Plos Onesupporting

confidence: 88%

Aortic Agatston score correlates with the progression of acute type A aortic dissection

et al. 2022

View full text Add to dashboard Cite

Aortic calcification in the tunica media is correlated with aortic stiffness, elastin degradation, and wall shear stress. The study aim was to determine if aortic calcifications influence disease progression in patients with acute type A aortic dissection (ATAAD). We retrospectively reviewed a total of 103 consecutive patients who had undergone surgery for ATAAD at our institution between January 2009 and December 2019. Of these, 85 patients who had preoperatively undergone plain computed tomography angiography (CTA) for evaluation of their aortic calcification were included. Moreover, we assessed the progression of aortic dissection after surgery via postoperative CTA. Using a classification and regression tree to identify aortic Agatston score thresholds predictive of disease progression, the patients were classified into high-score (Agatston score ≥ 3344; n = 36) and low-score (<3344; n = 49) groups. Correlations between aortic Agatston scores and CTA variables were assessed. Higher aortic Agatston scores were significantly correlated with the smaller distal extent of aortic dissection (p < 0.001), larger true lumen areas of the ascending (p = 0.009) and descending aorta (p = 0.002), and smaller false lumen areas of the descending aorta (p = 0.028). Patients in the high-score group were more likely to have DeBakey type II dissection (p = 0.001) and false lumen thrombosis (p = 0.027) than those in the low-score group, thereby confirming the correlations. Aortic dissection in the high-score group was significantly less distally extended (p < 0.001). A higher aortic Agatston score correlates with the larger true lumen area of the ascending and descending aorta and the less distal progression of aortic dissection in patients with ATAAD. Interestingly, the findings before and after surgery were consistent. Hence, aortic Agatston scores are associated with aortic dissection progression and may help predict postoperative residual dissected aorta remodeling.

show abstract

Section: Plos Onesupporting

confidence: 88%

Aortic Agatston score correlates with the progression of acute type A aortic dissection

et al. 2022

View full text Add to dashboard Cite

show abstract

“…The Stanford Classification categorizes AD into type A, which includes all dissections involving the ascending aorta (DeBakey type I and II), and type B, which includes dissections involving only the descending aorta (DeBakey type III) [ 13 ]. In a triage setting, the Stanford classification has the advantage of classifying ADs into cases which require surgical intervention - type A, and those which can be managed conservatively- type B (with the exception of complicated type B) [ 14 ].…”

Section: Classificationmentioning

confidence: 99%

Aortic Dissection: A Review of the Pathophysiology, Management and Prospective Advances

Sayed

Munir

Bahbah

2021

CCR

View full text Add to dashboard Cite

: Aortic dissection is an emergent medical condition, generally affecting the elderly, characterized by a separation of the aortic wall layers and subsequent creation of a pseudolumen that may compress the true aortic lumen. Predisposing factors mediate their risk by either increasing tension on the wall or by causing structural degeneration. They include hypertension, atherosclerosis, and a number of connective tissue diseases. If it goes undetected, aortic dissection carries a significant mortality risk; therefore, a high degree of clinical suspicion and a prompt diagnosis are required to maximize survival chances. Imaging methods, most commonly a CT scan, are essential for diagnosis; however, several studies have also investigated the effect of several biomarkers to aid in the detection of the condition. The choice of intervention varies depending on the type of dissection, with open surgical repair remaining of choice in those with type. A dissections; however, the role of conventional open surgery has considerably diminished in complicated type B dissections, with endovascular repair, a much less invasive technique, proving more effective. In uncomplicated type B dissections, where medical choice reigned supreme as the optimal intervention, endovascular repair is being explored as a viable option which may reduce long term mortality outcomes, although the ideal intervention in this situation is far from settled.

show abstract

Clinical presentation of two phenotypes of tooth wear patients

Hammoudi

Trulsson

Smedberg

et al. 2019

Journal of Dentistry

View full text Add to dashboard Cite

Cluster analysis of acute ascending aortic dissection provides novel insight into mechanisms of distal progression

Cited by 5 publications

References 16 publications

Aortic Agatston score correlates with the progression of acute type A aortic dissection

Aortic Agatston score correlates with the progression of acute type A aortic dissection

Aortic Dissection: A Review of the Pathophysiology, Management and Prospective Advances

Clinical presentation of two phenotypes of tooth wear patients

Contact Info

Product

Resources

About