Differences of patients’ characteristics in acute type A aortic dissection – surgical data from Belgian and Japanese centers-

Abstract

BackgroundIt is well known that there are major differences between the Japanese and Western population regarding the incidence of ischemic heart disease and stroke. The purpose of this study was to evaluate differences of patients’ characteristics between Belgian and Japanese cohort with acute type A aortic dissection.MethodsIn 487 patients (297 male patients, mean age 61.9 ± 12.2 yrs) who underwent surgery for acute type A aortic dissection, baseline preoperative and intraoperative data were collected. Belgian patients (n = 237) were compared to Japanese patients (n = 250). Clinical data included patient demographics, history, status at presentation, imaging study results and intraoperative findings.ResultsThe Japanese cohort had significantly more women (48.8% vs. 28.7%, p < 0.0001), lower BMI (24.2 vs. 26.4, p < 0.0001) and lower prevalence of hypertension (49.2% vs. 65.8%, p = 0.0002). More DeBakey type I dissections and less type III dissections with retrograde extension were reported in Belgium than in Japan (77.2% vs. 48.4%, p < 0.0001, 3.4% vs. 38.7%, p < 0.0001, respectively). More entries were found in the ascending aorta (78.5% vs. 58.5%, p < 0.0001) and aortic arch (24.9% vs. 13.7%, p = 0.0018) in Belgian patients than in Japanese patients, who had more entries in the descending aorta or undetected entries.ConclusionsIn acute type A aortic dissection, Belgian patients reveal striking differences from Japanese patients regarding gender distribution, entry tear location and type of dissection. Japanese women are more likely to develop acute type A aortic dissection than Belgian women. (234 words).

Clinical features and risk factors of postoperative in-hospital mortality following surgical repair of Stanford type A acute aortic dissection

“…Our study showed that the AAD patients have elevated mean systolic pressure, leukocyte count and D-dimer level. These results are slightly different from the previous results [ 33 , 34 ]. The increased mean systolic pressure may be related to decompensation for myocardial ischemia in the patients, while the increased leukocyte count might result from inflammation due to the tear of vascular intima.…”

Brachiocephalic artery dissection is a marker of stroke after acute type A aortic dissection repair

“…Stroke is a highly morbid complication of acute type A aortic dissection (ATAAD) repair with reported incidence rates of 10%–30% 1–3 . Factors related to stroke after ATAAD repair, including the selection of arterial cannulation site, brain protection method, optimal temperature control, and range of replaced aorta, had been reported 2,4–14 …”

Likelihood of Aortic Valve Preservation During Repair of Acute Type A Aortic Dissection

“…Our study is limited by the retrospective nature of the review as well as being a single-center study, although our patient population's baseline characteristics in terms of age, gender, and comorbidities are similar to previously reported Western series. 15 Additional limitations of our study include the relatively low rate (33%) of follow-up imaging studies of our population and the possibility that patients lost to follow up required reoperation at other centers without our knowledge. When contacting patients in the study who did not have echocardiographic or computed tomography follow-up the most common explanation was that the imaging was not covered by medical insurance (or they did not have insurance to begin with) and would present a financial hardship.…”