Acute aortic dissections with entry tear in the arch: A report from the International Registry of Acute Aortic Dissection Santi Trimarchi, MD, PhD, Hector.

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Presentation transcript:

Acute aortic dissections with entry tear in the arch: A report from the International Registry of Acute Aortic Dissection Santi Trimarchi, MD, PhD, Hector W.L. de Beaufort, MD, Jip L. Tolenaar, MD, PhD, Joseph E. Bavaria, MD, Nimesh D. Desai, MD, PhD, Marco Di Eusanio, MD, PhD, Roberto Di Bartolomeo, MD, Mark D. Peterson, MD, PhD, Marek Ehrlich, MD, Arturo Evangelista, MD, Daniel G. Montgomery, BS, Truls Myrmel, MD, PhD, G. Chad Hughes, MD, Jehangir J. Appoo, MD, Carlo De Vincentiis, MD, Tristan D. Yan, MD, PhD, Christoph A. Nienaber, MD, PhD, Eric M. Isselbacher, MD, G. Michael Deeb, MD, Thomas G. Gleason, MD, Himanshu J. Patel, MD, Thoralf M. Sundt, MD, Kim A. Eagle, MD The Journal of Thoracic and Cardiovascular Surgery Volume 157, Issue 1, Pages 66-73 (January 2019) DOI: 10.1016/j.jtcvs.2018.07.101 Copyright © 2018 Terms and Conditions

The Journal of Thoracic and Cardiovascular Surgery 2019 157, 66-73DOI: (10.1016/j.jtcvs.2018.07.101) Copyright © 2018 Terms and Conditions

Figure 1 Acute aortic dissection with primary entry tear in the arch and retrograde extension into the ascending aorta, with or without extension into the descending aorta (arch A group, 1) or no ascending involvement and antegrade extension into the descending aorta or further distally (arch B group, 2). The Journal of Thoracic and Cardiovascular Surgery 2019 157, 66-73DOI: (10.1016/j.jtcvs.2018.07.101) Copyright © 2018 Terms and Conditions

Figure 2 Computed tomography angiography scan of a patient with acute aortic dissection and primary entry tear between the innominate artery and the left common carotid artery with retrograde extension of dissection into the ascending aorta and antegrade extension into the descending aorta (arch A). The Journal of Thoracic and Cardiovascular Surgery 2019 157, 66-73DOI: (10.1016/j.jtcvs.2018.07.101) Copyright © 2018 Terms and Conditions

Figure 3 Computed tomography angiography scan of a patient with acute aortic dissection and primary entry tear between the origin of the innominate artery and the left common carotid artery and no ascending involvement (arch B). The Journal of Thoracic and Cardiovascular Surgery 2019 157, 66-73DOI: (10.1016/j.jtcvs.2018.07.101) Copyright © 2018 Terms and Conditions

Figure 4 Flow chart describing numerically the number of patients excluded for each reason. *In some patients, there was more than 1 reason for exclusion. The Journal of Thoracic and Cardiovascular Surgery 2019 157, 66-73DOI: (10.1016/j.jtcvs.2018.07.101) Copyright © 2018 Terms and Conditions

Figure 5 Management of acute aortic dissections with primary entry tear in the arch. The remaining 2.7% of patients in group 1 and 5.0% in group 2 were treated with hybrid surgical/endovascular methods. The Journal of Thoracic and Cardiovascular Surgery 2019 157, 66-73DOI: (10.1016/j.jtcvs.2018.07.101) Copyright © 2018 Terms and Conditions

Figure 6 In-hospital mortality. Overall and by management type of acute aortic dissections with primary entry tear in the arch. The Journal of Thoracic and Cardiovascular Surgery 2019 157, 66-73DOI: (10.1016/j.jtcvs.2018.07.101) Copyright © 2018 Terms and Conditions

Figure 7 Classification, management, and in-hospital mortality of acute aortic dissections with primary entry tear in the arch. The Journal of Thoracic and Cardiovascular Surgery 2019 157, 66-73DOI: (10.1016/j.jtcvs.2018.07.101) Copyright © 2018 Terms and Conditions

Classification, management, and in-hospital mortality of acute aortic dissections with primary entry tear in the arch. The Journal of Thoracic and Cardiovascular Surgery 2019 157, 66-73DOI: (10.1016/j.jtcvs.2018.07.101) Copyright © 2018 Terms and Conditions

The Journal of Thoracic and Cardiovascular Surgery 2019 157, 66-73DOI: (10.1016/j.jtcvs.2018.07.101) Copyright © 2018 Terms and Conditions