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Novel and Innovative Hybrid Technique for Type A Aortic Dissection
Published on: March 28, 2025
Stroke and outcomes in patients with acute type A aortic dissection
Eduardo Bossone1, David C Corteville, Kevin M Harris
1Department of Cardiology, University of Salerno, Salerno, Italy (E.B.); Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI (D.C.C., E.K.-R., D.G.M., K.A.E.); Abbott-Northwestern Hospital, Minneapolis Heart Institute, Minneapolis, MN (K.M.H.); Department of Cardiovascular Medicine, University of Tokyo, Tokyo, Japan (T.S.); Department of Interventional Cardiology, San Salvatore Hospital, Pesaro, Italy (R.F.); Department of Cardiac Sciences, University of Calgary, Calgary, Canada (S.H.); Department of Cardiothoracic Surgery, University of Vienna, Vienna, Austria (M.P.E.); Division of Medical Genetics, University of Pennsylvania, Philadelphia, PA (R.E.P.); Department of Cardiology, Hôpital Bichat, Paris, France (P.G.S.); Division of Cardiovascular Surgery, Mayo Clinic, Rochester, MN (K.G.); Servei de Cardiologia, Hospital General Universitari Vall d'Hebron, Barcelona, Spain (A.E.); Thoracic Aortic Center, Massachusetts General Hospital, Boston, MA (E.M.I.); and Department of Internal Medicine, University of Rostock, Rostock, Germany (C.A.N.).
Stroke is a serious complication of type A acute aortic dissection (TAAAD), affecting 6% of patients. While it increases in-hospital complications and mortality, stroke does not appear to impact long-term survival in TAAAD patients.
Area of Science:
- Cardiovascular Medicine
- Neurology
- Vascular Surgery
Background:
- Type A acute aortic dissection (TAAAD) is a life-threatening condition.
- Stroke is a known but poorly understood complication of TAAAD.
- Limited data exist on the incidence and prognostic significance of stroke in TAAAD.
Purpose of the Study:
- To determine the incidence of stroke in patients with TAAAD.
- To investigate the association between stroke and in-hospital and long-term outcomes in TAAAD patients.
Main Methods:
- Retrospective analysis of 2202 patients from the International Registry of Acute Aortic Dissection.
- Comparison of clinical characteristics, presentation, management, and outcomes between TAAAD patients with and without stroke.
- Statistical analysis including odds ratios and hazard ratios to assess prognostic impact.
Main Results:
- Stroke was present in 6.0% of TAAAD patients, who were older and had higher rates of hypertension and atherosclerosis.
- Patients with stroke presented less with chest pain and more with syncope, shock, or pulse deficits, often involving arch vessels.
- TAAAD patients with stroke experienced longer hospital stays, increased in-hospital complications, and higher in-hospital mortality, but similar long-term mortality after hospital survival.
Conclusions:
- Stroke is a significant complication of TAAAD, associated with increased in-hospital morbidity and mortality.
- Stroke does not appear to adversely affect long-term survival in TAAAD patients who survive hospitalization.
- Further research is needed to evaluate the impact of aggressive early interventions on outcomes in TAAAD patients with stroke.
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