Related Experiment Video

Updated: Jun 12, 2026

Novel and Innovative Hybrid Technique for Type A Aortic Dissection
06:26

Novel and Innovative Hybrid Technique for Type A Aortic Dissection

Published on: March 28, 2025

Management of type A aortic dissections: a meta-analysis of the literature

Frederik H W Jonker1, Felix J V Schlosser, Jeffrey E Indes

  • 1Department of Surgery and Radiology, Section of Vascular Surgery, Yale University School of Medicine, New Haven, Connecticut 06510, USA.

The Annals of Thoracic Surgery
|May 25, 2010
PubMed

Insights

Iatrogenic aortic dissections, often occurring during cardiac procedures, have a higher incidence with thoracic endovascular aortic repair. Early diagnosis and surgical repair significantly reduce in-hospital mortality for this serious complication.

Area of Science:

  • Cardiovascular Surgery
  • Medical Device Technology

Background:

  • Iatrogenic aortic dissections are a known complication of cardiovascular interventions.
  • Thoracic endovascular aortic repair (TEVAR) presents a higher incidence of type A aortic dissection compared to traditional cardiac surgery.

Purpose of the Study:

  • To investigate the management strategies and outcomes of type A iatrogenic aortic dissections.
  • To analyze the incidence and risk factors associated with iatrogenic aortic dissections.

Main Methods:

  • Systematic review and meta-analysis of published case series on type A iatrogenic aortic dissections.
  • Analysis of intraoperative diagnosis rates and surgical repair interventions.
  • Statistical analysis to determine factors influencing in-hospital mortality.

Main Results:

  • The majority of cases occurred during cardiac surgery, with a notably higher incidence during TEVAR.
  • Intraoperative diagnosis was achieved in 69% of patients, and 88% underwent surgical repair.
  • Overall in-hospital mortality was 38%, with intraoperative diagnosis and surgical repair significantly reducing mortality.

Conclusions:

  • Prompt intraoperative diagnosis and surgical repair are critical for improving outcomes in type A iatrogenic aortic dissections.
  • TEVAR is associated with a higher risk of iatrogenic aortic dissection compared to conventional cardiac surgery.

Related Concept Videos

Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
Aneurysm IV: Nursing Management01:22

Aneurysm IV: Nursing Management

Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
Aneurysm II: Clinical Manifestations and Diagnostic Studies01:21

Aneurysm II: Clinical Manifestations and Diagnostic Studies

Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
Aortic Regurgitation I: Introduction01:15

Aortic Regurgitation I: Introduction

IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
Aneurysm I: Introduction01:30

Aneurysm I: Introduction

An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...