Proximal aortic dissection late after aortic valve surgery: 119 cases of a distinct clinical entity
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Proximal aortic dissection late after aortic valve surgery: 119 cases of a distinct clinical entity. / von Kodolitsch, Y.; Loose, R.; Ostermeyer, J.; Aydin, A.; Koschyk, D. H.; Haverich, A.; Nienaber, C. A.
in: THORAC CARDIOV SURG, Jahrgang 48, Nr. 6, 2000, S. 342-346.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Proximal aortic dissection late after aortic valve surgery: 119 cases of a distinct clinical entity
AU - von Kodolitsch, Y.
AU - Loose, R.
AU - Ostermeyer, J.
AU - Aydin, A.
AU - Koschyk, D. H.
AU - Haverich, A.
AU - Nienaber, C. A.
PY - 2000
Y1 - 2000
N2 - Background: Besides systemic hypertension and Marfan syndrome, only previous aortic valve replacement (AVR) is independently associated with proximal (type A) aortic dissection. Little, however, is known to date about the characteristic features of this clinical entity. Methods: Clinical, prognostic and predisposing profiles in 119 cases of dissection and/or aneurysm occuring 1 month to 16 years after routine AVR were analyzed comprising 62 cases from our database and 57 reported cases. Results: Dissection after AVR has been observed in 0.6% of all routine AVR procedures in the past four decades. With clinical signs, symptoms and anatomical features different from classic aortic dissection post-AVR dissection is a distinct clinical entity with a high intraoperative mortality of 44% and a 30-day and 5-year survival of 62% and 43%, respectively. Aortic regurgitation and a thin and/or fragile aortic wall at AVR, however, predict late dissection. Using a prediction model, the risk of late dissection can be stratified based on information obtained during AVR surgery. Conclusions: Aortic dissection following AVR is likely to represent a distinct clinical entity which can be predicted and possibly prevented at AVR.
AB - Background: Besides systemic hypertension and Marfan syndrome, only previous aortic valve replacement (AVR) is independently associated with proximal (type A) aortic dissection. Little, however, is known to date about the characteristic features of this clinical entity. Methods: Clinical, prognostic and predisposing profiles in 119 cases of dissection and/or aneurysm occuring 1 month to 16 years after routine AVR were analyzed comprising 62 cases from our database and 57 reported cases. Results: Dissection after AVR has been observed in 0.6% of all routine AVR procedures in the past four decades. With clinical signs, symptoms and anatomical features different from classic aortic dissection post-AVR dissection is a distinct clinical entity with a high intraoperative mortality of 44% and a 30-day and 5-year survival of 62% and 43%, respectively. Aortic regurgitation and a thin and/or fragile aortic wall at AVR, however, predict late dissection. Using a prediction model, the risk of late dissection can be stratified based on information obtained during AVR surgery. Conclusions: Aortic dissection following AVR is likely to represent a distinct clinical entity which can be predicted and possibly prevented at AVR.
KW - Aneurysm
KW - Aorta
KW - Risk factors
KW - Surgery
KW - Valves
UR - http://www.scopus.com/inward/record.url?scp=0034537677&partnerID=8YFLogxK
U2 - 10.1055/s-2000-8346
DO - 10.1055/s-2000-8346
M3 - SCORING: Journal article
C2 - 11145401
AN - SCOPUS:0034537677
VL - 48
SP - 342
EP - 346
JO - THORAC CARDIOV SURG
JF - THORAC CARDIOV SURG
SN - 0171-6425
IS - 6
ER -