Acute type B aortic dissection complicated by visceral ischemia

Objective Acute type B aortic dissection (ABAD) can lead to visceral malperfusion, a potentially life-threatening complication. The purpose of this study was to investigate the presentation, management, and outcomes of ABAD patients with visceral ischemia who are enrolled in the International Regist...

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Veröffentlicht in:	The Journal of thoracic and cardiovascular surgery 2015-04, Vol.149 (4), p.1081-1086.e1
Hauptverfasser:	Jonker, Frederik H.W., MD, PhD, Patel, Himanshu J., MD, Upchurch, Gilbert R., MD, Williams, David M., MD, Montgomery, Daniel G., BS, Gleason, Thomas G., MD, MS, Braverman, Alan C., MD, Sechtem, Udo, MD, Fattori, Rossella, MD, Di Eusanio, Marco, MD, PhD, Evangelista, Arturo, MD, Nienaber, Christoph A., MD, Isselbacher, Eric M., MD, Eagle, Kim A., MD, Trimarchi, Santi, MD, PhD
Format:	Artikel
Sprache:	eng
Schlagworte:	Acute Disease Acute Kidney Injury - complications Aged Aneurysm, Dissecting - complications Aneurysm, Dissecting - diagnosis Aneurysm, Dissecting - mortality Aneurysm, Dissecting - physiopathology Aneurysm, Dissecting - therapy Aortic Aneurysm - complications Aortic Aneurysm - diagnosis Aortic Aneurysm - mortality Aortic Aneurysm - physiopathology Aortic Aneurysm - therapy Cardiothoracic Surgery Chi-Square Distribution Early Diagnosis Endovascular Procedures - adverse effects Endovascular Procedures - mortality Europe Female Hospital Mortality Humans Ischemia - diagnosis Ischemia - etiology Ischemia - mortality Ischemia - physiopathology Ischemia - therapy Kaplan-Meier Estimate Linear Models Logistic Models Male Middle Aged Multivariate Analysis Odds Ratio Predictive Value of Tests Regional Blood Flow Registries Risk Assessment Risk Factors Time Factors Treatment Outcome United States Vascular Surgical Procedures - adverse effects Vascular Surgical Procedures - mortality Viscera - blood supply
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Zusammenfassung:	Objective Acute type B aortic dissection (ABAD) can lead to visceral malperfusion, a potentially life-threatening complication. The purpose of this study was to investigate the presentation, management, and outcomes of ABAD patients with visceral ischemia who are enrolled in the International Registry of Acute Aortic Dissection. Methods Patients with ABAD enrolled in the registry between 1996 and 2013 were identified and stratified based on presence of visceral ischemia at admission. Demographics, medical history, imaging results, management, and outcomes were compared for patients with versus without visceral ischemia. Results A total of 1456 ABAD patients were identified, of which 104 (7.1%) presented with visceral ischemia. Preoperative limb ischemia (28% vs 7%, P
ISSN:	0022-5223 1097-685X
DOI:	10.1016/j.jtcvs.2014.11.012