Abstract
Type A acute aortic dissection (AAD) is a life-threatening disease. The use of contrast-enhanced computed tomography (CT) for diagnosing AAD has increased, and CT can provide pathophysiologic information on dissection such as intramural hematoma (IMH), longitudinal extent of dissection, and branch vessel involvement. However, the prognostic impact of these CT findings is poorly investigated. This multicenter registry included 703 patients with type A AAD. The longitudinal extent of dissection and IMH was determined on CT. Branch vessel involvement was defined as dissection extended into coronary, cerebral, and visceral arteries on CT. The evidence of malperfusion was defined based on clinical presentations. The primary endpoint was in-hospital death. Of 703 patients, 126 (18%) died during hospitalization. Based on contrast-enhanced CT findings, longitudinal extent of dissection was not associated with in-hospital death, while patients with IMH had lower in-hospital mortality than those without (13% vs 22%, p = 0.004). Coronary, cerebral, and visceral artery involvement on CT was found in 6%, 55%, and 32%. In patients with coronary artery involvement, 90% had clinical coronary malperfusion, while only 25% and 21% of patients wit...Continue Reading
References
Feb 24, 2000·JAMA : the Journal of the American Medical Association·P G HaganK A Eagle
Mar 17, 2010·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Michelle A McMahon, Christopher A Squirrell
Mar 15, 2011·Clinical Cardiology·Hee Hwa HoHung Fat Tse
Feb 22, 2012·The Journal of Thoracic and Cardiovascular Surgery·Marco Di EusanioRossella Fattori
Aug 28, 2012·Circulation·Kristian ThygesenShanti Mendis
Nov 10, 2012·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Davide PaciniUNKNOWN RERIC (Emilia Romagna Cardiac Surgery Registry) Investigators
Apr 20, 2013·Circulation·Dominic P J HowardUNKNOWN Oxford Vascular Study
Aug 21, 2013·Journal of Emergencies, Trauma, and Shock·Youichi Yanagawa, Toshihisa Sakamoto
Jun 20, 2015·Journal of the American College of Cardiology·Martin CzernyThierry P Carrel
Jul 25, 2015·Journal of the American College of Cardiology·Linda A PapePatrick O'Gara
Apr 14, 2016·The American Journal of Cardiology·Yoshihiro TanakaMasakazu Yamagishi
Aug 18, 2016·JAMA : the Journal of the American Medical Association·Firas F MussaKim A Eagle
Apr 25, 2018·Circulation·Arturo EvangelistaUNKNOWN IRAD Investigators
Jun 5, 2018·Journal of Cardiovascular Computed Tomography·Chun-Chieh WangMing-Ting Wu
Nov 15, 2018·Heart, Lung & Circulation·Ang LiYiTong Ma
Dec 24, 2018·The Journal of Thoracic and Cardiovascular Surgery·Igor ZindovicShahab Nozohoor
Sep 11, 2019·Resuscitation·Emily PanAnders Jeppsson