Predicting In-Hospital Mortality in Acute Type B Aortic Dissection: Evidence From International Registry of Acute Aortic Dissection

Characteristics and Predictors of Mortality in Patients With Cardiovascular Shock in Japan – Results From the Japanese Circulation Society Cardiovascular Shock Registry –

“…Previous studies have reported high mortality rates in patients in the shock state with aortic disease; acute type A aortic dissection has a mortality rate of 40-50%, 17,25,26 type B aortic dissection is 43%, 27 and ruptured aortic aneurysm is 53%. 28 Furthermore, preoperative shock is reportedly an independent prognostic factor.…”

Update in the management of type B aortic dissection

“…34,35 Other independent predictors of mortality include periaortic hematoma and descending aortic diameter ⩾5.5 cm. 36 Moreover, size of the primary tear (>10 mm), one entry tear, entry tear in the inner curvature, false lumen diameter >22 mm, and elliptic true lumen combined with saccular false lumen are related to increased risk of aortic growth and complicated TBAD. [37][38][39][40] Finally, branch vessel involvement and a totally patent false lumen are associated with decreased complete thrombosis of the false lumen.…”

“…[37][38][39][40] Finally, branch vessel involvement and a totally patent false lumen are associated with decreased complete thrombosis of the false lumen. 36 These morphologic signs can predict complications and may therefore guide the choice of management strategy (Figure 2).…”

“…7 Other clinical signs associated with increased mortality in acute TBAD patients are acute renal failure, hypotension/shock, mesenteric ischemia, and limb ischemia, and therefore acute aortic repair should be considered to restore adequate blood perfusion. 36 Chronic medical treatment. For patients with uncomplicated TBAD, optimal medical treatment (OMT) is widely accepted as the standard initial management, 8,21,25,51 together with consideration of endovascular repair.…”

Biomarkers Investigation for In-Hospital Death in Patients With Stanford Type A Acute Aortic Dissection

“…7) A previous study has identified some predictors of inhospital mortality in acute type B aortic dissection including age, abrupt onset of chest pain, hypertension, kidney failure, pulse deficit, abnormal electrocardiography (ECG) findings, and absence of a nocturnal blood pressure fall. [8][9][10] Since patients with AAD usually receive medical treatment during the acute phase, Kudo, et al 11) suggest that maximum aortic diameter of ≥ 40 mm or ulcer-like projections at onset are predictors of aortic events. Actually, there is growing evidence that multiple assessments of several biomarkers may provide complementary information about the risk of death in aortic dissection patients.…”