Related Experiment Video
Updated: Aug 19, 2025
06:26
Novel and Innovative Hybrid Technique for Type A Aortic Dissection
Published on: March 28, 2025
445
Outcome after Surgery for Iatrogenic Acute Type A Aortic Dissection
Fausto Biancari1,2, Matteo Pettinari3, Giovanni Mariscalco4
1Department of Cardiac Surgery, Heart and Lung Center, Helsinki University Hospital, University of Helsinki, 00029 Helsinki, Finland.
Journal of Clinical Medicine
|November 26, 2022
Summary
Iatrogenic acute Stanford type A aortic dissection (TAAD) is rare but significantly increases in-hospital mortality compared to spontaneous TAAD, often due to postoperative heart failure. Long-term survival remains comparable between the two groups.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Interventional Cardiology
Background:
- Acute Stanford type A aortic dissection (TAAD) can complicate cardiovascular procedures.
- Data on outcomes following surgery for iatrogenic TAAD is limited.
Purpose of the Study:
- To investigate the incidence and outcomes of iatrogenic TAAD.
- To compare in-hospital and long-term mortality between iatrogenic and spontaneous TAAD.
Main Methods:
- Retrospective analysis of the European Registry of Type A Aortic Dissection (ERTAAD) database.
- Inclusion of 3902 patients who underwent surgery for acute TAAD.
- Propensity score matching to compare iatrogenic and spontaneous TAAD groups.
Main Results:
- Iatrogenic TAAD occurred in 2.6% of patients, primarily after cardiac surgery or percutaneous coronary intervention.
- In-hospital mortality was significantly higher for iatrogenic TAAD (30.4%) versus spontaneous TAAD (15.7%), linked to increased postoperative heart failure.
- Five-year mortality was similar between iatrogenic and spontaneous TAAD groups.
Conclusions:
- Iatrogenic TAAD is an uncommon but serious complication.
- Iatrogenic TAAD is associated with a substantially higher risk of in-hospital death.
- Despite higher acute mortality, long-term survival for iatrogenic TAAD is comparable to spontaneous TAAD.
Related Concept Videos
01:22Aneurysm IV: Nursing Management
16
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...
16
01:26Aneurysm III: Interprofessional Care
17
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...
17
01:15Aortic Regurgitation I: Introduction
25
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...
25
01:25Aortic Regurgitation III: Medical Management
32
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...
32
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies
18
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...
18
01:23Peripheral Artery Disease V: Postoperative Nursing Management
17
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
17