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Review
. 2014 Jul;3(4):368-74.
doi: 10.3978/j.issn.2225-319X.2014.07.06.

Acute type B aortic dissection: insights from the International Registry of Acute Aortic Dissection

Akshar Y Patel  1 , Kim A Eagle  1 , Prashant Vaishnava  1
Affiliations
Review

Acute type B aortic dissection: insights from the International Registry of Acute Aortic Dissection

Akshar Y Patel et al. Ann Cardiothorac Surg. 2014 Jul.

Abstract

Acute type B aortic dissection comprises approximately one-third of all aortic dissection cases. Although this catastrophic cardiovascular condition was first described in the medical literature over two centuries ago, data on the optimal diagnostic and treatment modalities for type B dissection was slow to evolve throughout the latter half of the twentieth century, even as newer diagnostic techniques and management strategies became commonplace. To further elucidate contemporary practice patterns and outcomes of aortic dissection, the International Registry of Acute Aortic Dissection (IRAD) was established in 1996. Over the past two decades, IRAD publications have steadily increased our knowledge and understanding about aortic dissection. Specifically in recent years, analyses of IRAD data have gone beyond simply characterizing the patient with acute type B aortic dissection and have attempted to identify the means by which the outcome of such a patient could be improved. Thus, we present herein three areas in which IRAD data has recently advanced our understanding of acute type B aortic dissection: temporal classification especially for the subacute time period, risk stratification for identifying complicated cases, and thoracic endovascular aortic repair (TEVAR).

Keywords: International Registry of Acute Aortic Dissection (IRAD); Type B dissection; acute aortic dissection; aorta; thoracic endovascular aortic repair (TEVAR).

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Figures

Figure 1
Figure 1
IRAD centers worldwide. IRAD, International Registry of Acute Aortic Dissection.
Figure 2
Figure 2
Kaplan-Meier survival curves for type B dissection stratified by time (13).
Figure 3
Figure 3
In-hospital mortality rates in uncomplicated versus complicated (refractory pain or hypertension) groups with medical management (19).
Figure 4
Figure 4
In-hospital mortality of complicated acute type B aortic dissection in different age groups (22).
Figure 5
Figure 5
Kaplan-Meier survival estimates for TEVAR compared to optimal medical management alone (23). TEVAR, thoracic endovascular aortic repair.
Video
Video
Acute type B aortic dissection: insights from the International Registry of Acute Aortic Dissection.
See this image and copyright information in PMC

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