Endovascular Therapy for Aortic Dissection

Wang, David S.; Dake, Michael D.

doi:10.1007/3-540-38309-3_19

Cited by 3 publications

(4 citation statements)

References 119 publications

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“…Based on reports from predominantly Western centers, the gender distribution in TA-AAD has always been described as a 2:1 male:female ratio [10–12]. This 2:1 male/female ratio is frequently reported by IRAD and can be found in many textbooks of cardiac surgery [13, 14]. But does this ratio hold true for the Eastern population?…”

Section: Discussionmentioning

confidence: 99%

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

Goda

Minami

Imoto

et al. 2018

J Cardiothorac Surg

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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).

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Section: Discussionmentioning

confidence: 99%

“…Within TA-AAD patients, type I dissections are the predominant form (in Western series), and in up to 60–68% of cases, the location of the entry tear is within the ascending aorta [ 13 , 14 , 26 ]. Our observation confirmed this pattern and the main entry tear location.…”

Section: Discussionmentioning

confidence: 99%

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

Goda

Minami

Imoto

et al. 2018

J Cardiothorac Surg

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“…Whether the intramural hematoma precedes the intimal tear or vice versa is not settled. Aortic dissection occurs with a frequency of 2.6-3.5 per 100,000 personyears and is highly lethal, with a mortality that increases 1-2% per hour after symptom onset Wang and Dake (2006). Tear and dissection appear in the aorta when the stresses acting on its wall rise beyond its elastic limit.…”

Section: Introductionmentioning

confidence: 99%

Fluid–structure interaction analysis of turbulent pulsatile flow within a layered aortic wall as related to aortic dissection

Khanafer

Berguer

2009

Journal of Biomechanics

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“…It is assumed that, if the mechanical stresses applied to the aorta wall exceed some critical value combined with certain medical conditions, rupture occurs, propagating in the axial direction following a spiroidal path and splitting the inner two‐thirds and outer one‐third of the media layer apart . According to recent studies, aortic wall dissection occurs for 2.6–3.5 per 100,000 person‐years, with a mortality increase of up to 2% per hour after symptoms have been detected . Even though the general assumption is that high mechanical stresses causing inner tissue rupture in the aorta are a significant factor, the underlying mechanism of aorta dissection is poorly understood.…”

Section: Introductionmentioning

confidence: 99%

A three‐layer model for buckling of a human aortic segment under specific flow‐pressure conditions

Amabili

Karazis

Mongrain

et al. 2012

Numer Methods Biomed Eng

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Human aortas are subjected to large mechanical stresses because of blood flow pressurization and through contact with the surrounding tissue. It is essential that the aorta does not lose stability by buckling with deformation of the cross-section (shell-like buckling) (i) for its proper functioning to ensure blood flow and (ii) to avoid high stresses in the aortic wall. A numerical bifurcation analysis employs a refined reduced-order model to investigate the stability of a straight aorta segment conveying blood flow. The structural model assumes a nonlinear cylindrical orthotropic laminated composite shell composed of three layers representing the tunica intima, media and adventitia. Residual stresses because of pressurization are evaluated and included in the model. The fluid is formulated using a hybrid model that contains the unsteady effects obtained from linear potential flow theory and the steady viscous effects obtained from the time-averaged Navier-Stokes equations. The aortic segment loses stability by divergence with deformation of the cross-section at a critical flow velocity for a given static pressure, exhibiting a strong subcritical behaviour with partial or total collapse of the inner wall. Preliminary results suggest directions for further study in relation to the appearance and growth of dissection in the aorta.

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Endovascular Therapy for Aortic Dissection

Cited by 3 publications

References 119 publications

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

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

Fluid–structure interaction analysis of turbulent pulsatile flow within a layered aortic wall as related to aortic dissection

A three‐layer model for buckling of a human aortic segment under specific flow‐pressure conditions

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