Initial medical management in acute type A aortic dissection patients with a thrombosed false lumen in the ascending aorta combining intramural hematoma and retrograde dissection from the descending to the ascending aorta
| العنوان: | Initial medical management in acute type A aortic dissection patients with a thrombosed false lumen in the ascending aorta combining intramural hematoma and retrograde dissection from the descending to the ascending aorta |
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| المؤلفون: | Jun-Ichiro Nishi, Hiroshi Yasunaga, Shuichiro Sagara, Susumu Takase, Tomokazu Kosuga, Kenji Sadamatsu, Hideki Tashiro, Kensuke Ohe |
| المصدر: | European Heart Journal. Acute Cardiovascular Care. 9:S13-S20 |
| بيانات النشر: | Oxford University Press (OUP), 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Male, medicine.medical_specialty, False lumen, Aorta, Thoracic, Dissection (medical), 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, 03 medical and health sciences, 0302 clinical medicine, medicine.artery, Intensive care, Ascending aorta, medicine, Humans, 030212 general & internal medicine, Aged, Retrospective Studies, Aortic dissection, Hematoma, Aorta, Aortic Aneurysm, Thoracic, business.industry, Endovascular Procedures, Thrombosis, Syndrome, General Medicine, medicine.disease, Aortic Dissection, Acute type, Acute Disease, Female, Radiology, Tomography, X-Ray Computed, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies |
| الوصف: | Background:The feasibility of medical management for select patients with acute type A aortic dissection has been reported from a few institutions. In this study, we retrospectively investigated the safety and feasibility of our conservative approach for patients with type A aortic dissection in daily practice.Methods:From January 2013 to December 2017, 131 consecutive patients were admitted to our institution for acute aortic dissection, including 58 patients of type A. Initial medical management was attempted in select patients who were clinically stable and had a thrombosed false lumen of the ascending aorta without ulcer-like projections in the ascending aorta.Results:Except for nine patients contraindicated for surgery, urgent surgery was performed in 26 patients (SRG group), while 23 patients (MED group) were treated with the initial medical management. The maximum diameter of the ascending aorta was significantly larger in the SRG group than in the MED group. In the MED group, the heart rate and blood pressures were well-controlled at admission to the intensive-care unit, and the systolic blood pressure was further reduced at 24 h after. The in-hospital mortality rates of the MED and SRG groups were 0% and 15%, respectively. During the follow-up period, the survival rate was significantly higher in the MED group than in the SRG group, and the aortic event-free survival at one year was 80%.Conclusions:The initial medical management for select patients with a thrombosed false lumen in the ascending aorta was a safe and feasible strategy in real-world practice. |
| تدمد: | 2048-8734 2048-8726 |
| DOI: | 10.1177/2048872618777724 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::0252795e719d6b7957148140ec15549f https://doi.org/10.1177/2048872618777724 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....0252795e719d6b7957148140ec15549f |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 20488734 20488726 |
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| DOI: | 10.1177/2048872618777724 |