The Role of Age in Complicated Acute Type B Aortic Dissection

Jonker, Frederik H.W.; Trimarchi, Santi; Muhs, Bart E.; Rampoldi, Vincenzo; Montgomery, Daniel; Froehlich, James B.; Peterson, Mark D.; Bartnes, Kristian; Gourineni, Venu; Ramanath, Vijay S.; Braverman, Alan C.; Nienaber, Christoph; Isselbacher, Eric M.; Eagle, Kim A.

doi:10.1016/j.athoracsur.2013.06.056

Cited by 32 publications

(22 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Patients above 70 years of age had a significantly higher rate of mortality as compared with those below 70 years of age. It has been shown in previous studies that older age, especially above 70 years, is independently associated with an increased risk of poor prognosis, 16,[19][20][21] consistent with our findings. In addition to the age-related decrease in physical activity and functional fitness as well as the increase in comorbidities such as atherosclerosis that may adversely affect the outcomes, advanced age was associated with less administration of surgery, which might adversely affect the outcomes in patients with type A AD.…”

Section: Discussionsupporting

confidence: 93%

See 1 more Smart Citation

Influence of Age on Clinical Presentation, Therapeutic Options, and Outcome in Chinese Patients with Acute Aortic Dissection

Huang

Chen

et al. 2019

Int. Heart J.

View full text Add to dashboard Cite

It has been shown in previous studies that Chinese patients with acute aortic dissection (AD) were approximately 10 years younger than patients from western countries. However, there is a lack of studies concerning the age-related differences in clinical characteristics and outcomes in Chinese patients with acute AD. A total of 1,061 patients with AD (570 type A and 491 type B AD) were enrolled between 2006 and 2008. The clinical characteristics were compared between the patients in our study and those in the International Registry of Acute Aortic Dissection (IRAD). Compared with patients in the IRAD, those in our study were relatively younger, comprised more males, and had a higher proportion of Marfan syndrome but received fewer surgical interventions. When stratified by 10-year age, younger patients were more likely to have type A AD, familial AD, and Marfan syndrome, whereas older patients tended to comprise more females and type B AD. As age increased, the proportion of surgical intervention gradually decreased regardless of the type of AD. During a median follow-up of 2.2 years, 147 patients died, of whom 94 (63.9%) had type A AD and 53 (36.1%) had type B AD. Long-term mortality increased with increasing age, especially in patients above 70 years old. Furthermore, the recurrence rate of AD was higher in both the young and the older patients. In conclusion, compared with western patients with AD, Chinese patients have distinct characteristics and more attention should be paid to the young and older patients because of their high long-term mortality and recurrence rate.

show abstract

Section: Discussionsupporting

confidence: 93%

“…Data of laboratory tests, including white blood cell (WBC) counts; platelet counts; and C-reactive protein, D-dimer, and creatinine values, were obtained. Other recorded data included imaging examinations and in-hospital management, 1) and Jonker, et al 20) with permission.…”

Section: Methodsmentioning

confidence: 99%

Influence of Age on Clinical Presentation, Therapeutic Options, and Outcome in Chinese Patients with Acute Aortic Dissection

Huang

Chen

et al. 2019

Int. Heart J.

View full text Add to dashboard Cite

show abstract

“…In this cohort, patients with visceral ischemia were slightly but significantly younger than patients without visceral ischemia (59 vs 64 years) and often had malperfusion of other organs associated. On average, Type B AD patients with visceral ischemia are younger than patients without visceral ischemia [3,4].…”

Section: Incidence and Prognostic Valuementioning

confidence: 99%

Visceral Ischemia During Type B Dissection: Incidence, Prognostic Value, Diagnosis, and Operative Management

Spinelli

Beaufort

Trimarchi

2019

Visceral Vessels and Aortic Repair

Self Cite

View full text Add to dashboard Cite

“…In 2006, Bockler et al [10] reported a 30-day mortality rate of 19% in patients with acute complicated TBADs versus 0% in patients with chronic TBADs. Systemic hypertension has been reported as one of the most important risk factors for acute TBAD, present in about 80% of patients [1], as well as increasing age, atherosclerosis, and taller stature [11–14]. …”

Section: Introductionmentioning

confidence: 99%

Endovascular Repair in Acute Complicated Type B Aortic Dissection: 3-Year Results from the Valiant US Investigational Device Exemption Study

Lim¹

2017

Korean J Thorac Cardiovasc Surg

View full text Add to dashboard Cite

Acute complicated type B aortic dissection (TBAD) is a potentially catastrophic, life-threatening condition. If left untreated, there is a high risk of aortic rupture, irreversible organ or limb damage, or death. Several risk factors have been associated with acute complicated TBAD, including age and refractory hypertension. In the acute phase, even uncomplicated patients are more prone to develop complications if hypertension and pain are left medically untreated. Innovations in stent graft technologies have incrementally improved outcomes since their first use for this condition in 1999, though improvement is needed in mitigating periprocedural complications, adverse events, and mortality. In the past decade, endovascular repair has become the preferred treatment because of its superior outcomes to open repair and medical therapy. The Valiant Captivia Thoracic Stent Graft System is a third-generation endovascular stent graft with advancements in minimally invasive delivery, conformability to the anatomy, and the minimization of adverse sequelae. Herein, this stent graft is briefly reviewed and its 3-year outcomes are presented. Freedom from all-cause and dissection-related mortality was 79.1% and 90.0%, respectively. The Valiant Captivia Stent Graft represents a safe, effective intervention for acute complicated TBAD. Continued surveillance is needed to verify its longer-term durability.

show abstract

The Role of Age in Complicated Acute Type B Aortic Dissection

Cited by 32 publications

References 33 publications

Influence of Age on Clinical Presentation, Therapeutic Options, and Outcome in Chinese Patients with Acute Aortic Dissection

Influence of Age on Clinical Presentation, Therapeutic Options, and Outcome in Chinese Patients with Acute Aortic Dissection

Visceral Ischemia During Type B Dissection: Incidence, Prognostic Value, Diagnosis, and Operative Management

Endovascular Repair in Acute Complicated Type B Aortic Dissection: 3-Year Results from the Valiant US Investigational Device Exemption Study

Contact Info

Product

Resources

About