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Relationship of acute type A aortic dissection and disseminated intravascular coagulation

Daisuke Arima1, Yoshihiro Suematsu1, Ryotaro Yamada1

  • 1Department of Cardiovascular Surgery, Tsukuba Memorial Hospital, Tsukuba, Japan.

Journal of Vascular Surgery
|January 9, 2022
PubMed

Insights

High preoperative disseminated intravascular coagulation (DIC) scores in acute type A aortic dissection (ATAAD) patients correlate with larger false lumen dimensions. This finding may inform risk stratification and treatment strategies for ATAAD.

Area of Science:

  • Cardiology
  • Vascular Surgery
  • Hematology

Background:

  • Acute type A aortic dissection (ATAAD) is a life-threatening condition often complicated by disseminated intravascular coagulation (DIC).
  • The precise relationship between the severity of DIC and the anatomical characteristics of the false lumen in ATAAD remains incompletely understood.
  • Understanding this association is crucial for predicting outcomes and guiding therapeutic interventions.

Purpose of the Study:

  • To investigate the correlation between preoperative Japanese Association for Acute Medicine (JAAM) DIC scores and false lumen dimensions in patients with ATAAD.
  • To evaluate the association between DIC severity and specific ATAAD morphologies, such as communicating-type dissections.
  • To explore the potential impact of DIC severity on treatment outcomes in ATAAD.

Main Methods:

  • Retrospective analysis of 124 ATAAD patients treated between January 2012 and January 2020.
  • Correlation analysis using linear regression between preoperative JAAM DIC scores and false lumen diameter/length measured by computed tomography.
  • Comparison of outcomes between low and high JAAM DIC score groups.

Main Results:

  • A significant positive correlation was found between JAAM DIC scores and ascending false lumen diameter (r=0.32, P<.001) and dissection length (r=0.29, P=.001).
  • Patients with high JAAM DIC scores exhibited larger ascending false lumen diameters compared to those with low scores (P<.05).
  • High JAAM DIC scores were significantly associated with communicating-type ATAAD (P<.05).

Conclusions:

  • Elevated preoperative JAAM DIC scores in ATAAD are indicative of a larger false lumen and a communicating-type dissection.
  • These findings suggest that DIC severity is a valuable marker for assessing the extent and complexity of ATAAD.
  • Further research is warranted to elucidate the prognostic implications of these associations on patient outcomes.
Abstract

Keywords:
Acute type A aortic dissectionCoagulation-fibrinolysis markerComputed tomographyDisseminated intravascular coagulationFibrinolysisStanford type A

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