Follow-up of acute aortic dissection

Area of Science:

• Cardiology
• Vascular Surgery
• Emergency Medicine

Background:

• Aortic dissection is a critical medical emergency with high mortality if untreated.
• It is classified into Type A and Type B, with diagnosis often delayed due to low clinical suspicion.
• The natural history and optimal management strategies for aortic dissection require further elucidation.

Purpose of the Study:

• To enhance the diagnostic accuracy of aortic dissection.
• To promote the utilization of transesophageal echocardiography in emergency settings.
• To clarify the impact of prompt treatment on the prognosis of aortic dissection.

Main Methods:

• Ethical approval and informed consent were obtained for all participants.
• Expert cardiologists conducted clinical evaluations using various diagnostic modalities.
• A comprehensive medical history and physical examination were performed, with a 24-month follow-up period.

Main Results:

• Eleven patients (7 with Type A, 4 with Type B) were studied; 9 had hypertension.
• Five patients underwent surgery for Type A dissection, with 4 surviving.
• Three deaths occurred, two in the emergency center and one post-surgery; all Type B dissections survived.

Conclusions:

• Clinical suspicion remains paramount for diagnosing aortic dissection and enabling life-saving interventions.
• Transesophageal echocardiography is an invaluable tool for rapid diagnosis, guiding treatment and follow-up.
• Widespread availability of transesophageal echocardiography in emergency departments is crucial for timely management.