BACKGROUND: Acute aortic dissection type A (AADA) is a life-threatening vascular emergency. Clinical presentation ranges from pain related to the acute event, collapse due to aortic rupture or pericardial tamponade, or manifestations of organ or limb ischaemia. The purpose of this review was to clarify important clinical issues of AADA management, with a focus on diagnostic and therapeutic challenges. METHODS: Based on a MEDLINE search the latest literature on this topic was reviewed. Results from the German Registry for Acute Aortic Dissection Type A (GERAADA) are also described. RESULTS: Currently, the perioperative mortality rate of AADA is below 20 per cent, the rate of definitive postoperative neurological impairment approaches 12 per cent and the long-term prognosis after surviving the acute phase of the disease is good. Many pathology- and therapy-associated factors influence the outcome of AADA, including prompt diagnosis with computed tomography and better cerebral protection strategies during aortic arch reconstruction. Endovascular technologies are emerging that may lead to less invasive treatment options. CONCLUSION: AADA is an emergency that can present with a wide variety of clinical scenarios. Advances in the surgical management of this complex disease are improving outcomes.
BACKGROUND: Acute aortic dissection type A (AADA) is a life-threatening vascular emergency. Clinical presentation ranges from pain related to the acute event, collapse due to aortic rupture or pericardial tamponade, or manifestations of organ or limb ischaemia. The purpose of this review was to clarify important clinical issues of AADA management, with a focus on diagnostic and therapeutic challenges. METHODS: Based on a MEDLINE search the latest literature on this topic was reviewed. Results from the German Registry for Acute Aortic Dissection Type A (GERAADA) are also described. RESULTS: Currently, the perioperative mortality rate of AADA is below 20 per cent, the rate of definitive postoperative neurological impairment approaches 12 per cent and the long-term prognosis after surviving the acute phase of the disease is good. Many pathology- and therapy-associated factors influence the outcome of AADA, including prompt diagnosis with computed tomography and better cerebral protection strategies during aortic arch reconstruction. Endovascular technologies are emerging that may lead to less invasive treatment options. CONCLUSION:AADA is an emergency that can present with a wide variety of clinical scenarios. Advances in the surgical management of this complex disease are improving outcomes.
Authors: Jerry Easo; Ernst Weigang; Philipp P F Hölzl; Michael Horst; Isabell Hoffmann; Maria Blettner; Otto E Dapunt Journal: Ann Cardiothorac Surg Date: 2013-03
Authors: Tyler M Gunn; Sotiris C Stamou; Nicholas T Kouchoukos; Kevin W Lobdell; Kamal Khabbaz; Lawrence H Patzelt; Robert C Hagberg Journal: Aorta (Stamford) Date: 2016-04-01
Authors: Yskert von Kodolitsch; Oliver Wilson; Helke Schüler; Axel Larena-Avellaneda; Tilo Kölbel; Sabine Wipper; Fiona Rohlffs; Christian Behrendt; E Sebastian Debus; Jens Brickwedel; Evaldas Girdauskas; Christian Detter; Alexander M Bernhardt; Jürgen Berger; Stefan Blankenberg; Hermann Reichenspurner; Tamer Ghazy; Klaus Matschke; Ralf-Thorsten Hoffmann; Norbert Weiss; Adrian Mahlmann Journal: Cardiovasc Diagn Ther Date: 2017-12