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. 2021 Apr 1;36(2):150-157.
doi: 10.21470/1678-9741-2020-0169.

Management of Acute Type A Aortic Dissection at a Public Cardiac Center in the Northeast Region of Brazil

Pablo Cesar Lustosa Barros Bezerra  1   2   3 , Ricardo de Carvalho Lima  1   3 , Pedro Rafael de Salerno  1   3 , Antonio Cavalcanti de Albuquerque Martins  2 , Geovanna Menezes de Medeiros Lustosa  2 , Alvaro Monteiro Perazzo  3 , Juliana Vieira de Oliveira Salerno  4 , Carolina Vieira de Oliveira Salerno  5 , Pedro Rafael Vieira de Oliveira Salerno  6
Affiliations

Management of Acute Type A Aortic Dissection at a Public Cardiac Center in the Northeast Region of Brazil

Pablo Cesar Lustosa Barros Bezerra et al. Braz J Cardiovasc Surg. .

Abstract

Introduction: Aortic diseases are among the most serious cardiovascular diseases; the overall mortality rate due to diseases such as aneurysms and aortic dissections has been estimated at 2.78 per 100,000 persons in 2010, with a higher mortality rate in men than women. Our objective was to evaluate the epidemiological profile of patients with acute type A aortic dissection at a cardiology referral center.

Methods: A retrospective cross-sectional study was performed at a public cardiac center with 24 patients hospitalized from 1/1/2016 to 12/31/2017 with a confirmed diagnosis of acute type A aortic dissection.

Results: Twenty (83.3%) out of 24 patients underwent surgery and four (16.7%) did not undergo surgery. Among those who underwent surgery, 10 (50%) died and 10 (50%) were discharged, and all non-operated patients died (P=0.114) (Fisher's exact test). The male gender predominated (n=19, 79.2%), 86.7% (n=13) of the patients presented body mass index > 25 kg/m2, chest pain was found in 91.7% (n=22), and renal failure was present in 45.8% (n=11) of the cases. Hypertension predominated in 91.7% (n=22) and the main exam was aortic angiotomography in 79.2% (n=19) of the cases.

Conclusion: The study presented a small sample size, making it impossible to associate the factors, although the service was considered a high-volume referral center. It is possible that the delay in arriving at the service and the accomplishment of invasive imaging with the use of contrast agents have aggravated the patients' condition and have been decisive for the increase in lethality, which requires further studies.

Keywords: Aneurysm, Dissecting; Aorta; Aortic Diseases; Body Mass Index; Cardiovascular Diseases; Hypertension; Referral and Consultation.

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Conflict of interest statement

No conflict of interest.

Figures

Fig. 1A to C
Fig. 1A to C
Angiotomography of one patient diagnosed with type A acute aortic dissection: A) transversal view; B) frontal view; C) 3D reconstruction view.
Fig. 2
Fig. 2
Crossover between surgical exposure and the final outcome (death or discharge). *Fisher’s exact test. P=0.114.
See this image and copyright information in PMC

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