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Non-A non-B aortic dissection: a systematic review and meta-analysis
Davide Carino1, Mrinal Singh2, Alberto Molardi1
1Department of Cardiac Surgery, Parma University Hospital, Parma, Italy.
Summary
Non-A non-B aortic dissections have a complicated course. Medical therapy shows higher 30-day mortality compared to interventions, suggesting early treatment may be beneficial for these rare aortic dissections.
Area of Science:
- Cardiovascular Medicine
- Vascular Surgery
- Medical Research
Background:
- Non-A non-B aortic dissections are rare and poorly understood.
- Limited data exists on their natural history and optimal management.
Purpose of the Study:
- To summarize the natural history of non-A non-B aortic dissections.
- To evaluate the outcomes of available therapeutic options.
Main Methods:
- Extensive MEDLINE literature search for studies on non-A non-B aortic dissection.
- Extracted data on medically treated patients to characterize natural history.
- Analyzed 30-day mortality, stroke, and retrograde type A dissection rates.
Main Results:
- Analyzed 14 studies involving 433 patients.
- 36% of patients received medical therapy, with a 14% 30-day mortality.
- Intervention showed lower 30-day mortality (3.6%), retrograde type A dissection (2.6%), and stroke (2.8%).
Conclusions:
- Non-A non-B dissections often require intervention due to complicated courses.
- Medical therapy appears to have higher 30-day mortality than surgical or endovascular options.
- Further prospective studies are needed to confirm the benefit of early intervention.
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