Predictability of aortic dissection as a function of aortic diameter

Sütsch, Gabor; Jenni, Rolf; Segesser, Ludwig von; Turina, M

doi:10.1093/eurheartj/12.12.1247

Cited by 33 publications

(19 citation statements)

References 10 publications

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“…Although with less emphasis on preventive surgery, the same concern about the risk of dissection in function of the size of the aorta exists in the general population [3,21]. The Yale group has provided an analysis of the natural history of aortic aneurysms, showing that larger aneurysms had a greater risk of dissection and rupture [22].…”

Section: Discussionmentioning

confidence: 99%

Limited role of aortic size in the genesis of acute type A aortic dissection

Neri

Barabesi

Buklas

et al. 2005

European Journal of Cardio-Thoracic Surgery

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Although aortic diameter remains a strong indication for preventive surgery in patients with inherited connective tissue disorders, acute aortic dissection occurs rarely in the setting of true ascending aortic aneurysms, and despite normal or near-normal aortic size in more than one-third of subjects. Dissection superimposing on small aortic diameters can be regarded as an expression of substantial functional tissue susceptibility to aortic catastrophic events.

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Section: Discussionmentioning

confidence: 99%

Limited role of aortic size in the genesis of acute type A aortic dissection

Neri

Barabesi

Buklas

et al. 2005

European Journal of Cardio-Thoracic Surgery

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“…3 Of those procedures, the most simple and conservative method is wrapping of the aorta. However, the problem with wrapping the ascending aorta is bulging or herniation of the aortic wall at the lips of the wrap.…”

Section: Discussionmentioning

confidence: 99%

“…However, it still remains controversial how to treat a dilated aorta at the time of AVR. 3,4 Additional operations for a dilated ascending aorta during the initial aortic valve surgery also increase the operative risk.…”

mentioning

confidence: 99%

Natural History of a Dilated Ascending Aorta After Aortic Valve Replacement

Matsuyama

Usui

Akita

et al. 2005

Circ J

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Background Little information is available regarding the incidence of aortic dissection or rupture in patients with a dilated ascending aorta after aortic valve replacement (AVR). The present clinical study aimed to demonstrate the incidence of aortic complications after AVR in patients with a dilated ascending aorta and to clarify those risk factors associated with the progression of a dilated ascending aorta or late aortic events. Methods and Results A total of 35 patients with a dilated ascending aorta at the time of AVR were enrolled. A dilated ascending aorta was defined as 40 mm or greater in diameter by preoperative computed tomography or operative findings. The baseline ascending aorta diameter ranged from 40 to 55 mm with a mean of 44.8±4.4 mm. There was a high frequency of bicuspid valve disease in patients with a dilated ascending aorta (57%). The mean follow-up interval was 8.1±3.5 years (range: 2.3-13). Aortic events occurred in 5 patients (aortic dissection in 1, rupture in 2, reoperation in 2) during the follow-up. One aortic dissection developed at a baseline aortic size of 42 mm, whereas 2 aortic ruptures occurred at baseline aortic sizes of 47 mm and 50 mm. There was no statistically significant univariate association between any of the patient clinical characteristics and late aortic events or ascending aortic progression. Conclusion Although the clinical course of patients with a dilated ascending aorta is unpredictable, aortic events may occur even in patients with a baseline aortic diameter of <50 mm. Therefore, preventive aortic surgery at the time of AVR should be considered to prevent aortic dissection or rupture in patients with an even slightly dilated ascending aorta with a diameter of 40 to 50 mm, unless the patient has a high operative risk or older age. (Circ J 2005; 69: 392 -396)

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“…Myxomas present between the ages of 30 -70 years, and occur more frequently in women [5,6]. The majority of myxomas (75-90%) originate in the LA from the fossa ovalis [5][6][7]. Clinical features include dyspnoea, syncope, arrhythmias, oedema, haemoptysis, and sudden death [2].…”

Section: Discussionmentioning

confidence: 99%

“…Clinical features include dyspnoea, syncope, arrhythmias, oedema, haemoptysis, and sudden death [2]. Systemic features of embolic phenomena (30-40%) [8] can result in pulmonary embolism, stroke and vasculitis and can mimic infective endocarditis [5][6][7][8]. However, 10-15% of patients are asymptomatic when a mass is incidentally found on imaging [7][8][9].…”

Section: Discussionmentioning

confidence: 99%

Left Atrial Myxoma With Concurrent Saddle Pulmonary Embolism and Duke’s B Colorectal Adenocarcinoma

Mehra

2013

J Med Cases

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A 64-year-old male with previous Duke's B adenocarcinoma of the colon, successfully treated with surgery and chemotherapy presented several months later with dyspnoea and atrial fibrillation. Investigations showed that he had a left atrial myxoma and a concurrent saddle pulmonary embolus. Full anticoagulation with unfractioned heparin was administered followed by surgical resection of the myxoma. Links between pulmonary emboli and underlying carcinoma are well established. However, to our knowledge, this is only the second case in the English literature where a patient has had both an adenocarcinoma of the colon and a myxoma. There are no links between a pulmonary saddle embolism and left atrial myxoma or between a right sided myxoma and a pulmonary saddle embolus and where the embolism is not a fragment of the myxoma.

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Predictability of aortic dissection as a function of aortic diameter

Abstract: KEY WORDS: Dissection of ascending aorta, echocardiography and aortic dissection, aortic diameter and dissection.

Cited by 33 publications

References 10 publications

Limited role of aortic size in the genesis of acute type A aortic dissection

Limited role of aortic size in the genesis of acute type A aortic dissection

Natural History of a Dilated Ascending Aorta After Aortic Valve Replacement

Left Atrial Myxoma With Concurrent Saddle Pulmonary Embolism and Duke’s B Colorectal Adenocarcinoma

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