Concomitant David’s operation and total arch replacement for acute type A aortic dissection

Shimazaki, Yasuhisa; Uesho, K.; Takeda, Fumihiro; Nakashima, Kentaro; Inui, Kiyoshige

doi:10.1007/bf02736701

Cited by 2 publications

(1 citation statement)

References 7 publications

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“…Acute heart failure (AHF) is rightly regarded not as a single disease but as a syndrome that can be caused by different mechanisms and different diseases. Although it is known that aortic dissection is one of the possible causes of AHF, the literature on the subject consists mainly of case reports . The only systematic approach to this issue dates back to 10 years ago .…”

Section: Introductionmentioning

confidence: 99%

Acute heart failure in patients with acute aortic syndrome: pathophysiology and clinical–prognostic implications

Vagnarelli

Corsini

Lorenzini

et al. 2015

European J of Heart Fail

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Aims Although acute heart failure (AHF) is a potential complication of acute aortic syndromes (AAS), its clinical details and management implications have been scarcely evaluated. This study aimed to assess prevalence, pathophysiological mechanisms, impact on treatment, and in‐hospital mortality of AHF in AAS. Methods and results Data were collected from a prospective AAS registry (398 patients diagnosed between 2000 and 2013). Patients with AHF were identified by the presence of dyspnoea as the presentation symptom or radiological signs of pulmonary congestion or cardiogenic shock, including patients with cardiac tamponade (CT). AHF frequency was 28% (Stanford type A 32% vs. type B 20%, P = 0.01). Four mechanisms leading to AHF were identified, alone or in combination: CT (26%), aortic regurgitation (25%), myocardial ischaemia (17%), and hypertensive crisis (10%). In type A patients, aortic regurgitation and CT were the most frequent mechanisms, whereas myocardial ischaemia and hypertensive crisis were the most frequent in type B patients. Although no difference was noted for diagnostic times, AHF at presentation led to a longer surgical delay in type A AAS. In‐hospital mortality was higher in patients with AHF compared with those without (34% vs. 17%, P < 0.001). After multivariable analysis, AHF was associated with increased risk of in‐hospital death (adjusted odds ratio 1.97, 95% confidence interval 1.14–3.36, P = 0.014). Conclusion AHF occurs in more than a quarter of patients with AAS of both type A and type B, is due to a variety of pathophysiological mechanisms, and is associated with increased surgical delay and in‐hospital mortality.

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Section: Introductionmentioning

confidence: 99%