Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Dec;39(Suppl 2):280-286.
doi: 10.1007/s12055-023-01548-x. Epub 2023 Jul 19.

Overview of acute type A dissection in Japan

Hiroaki Osada  1 , Kenji Minatoya  1
Affiliations
Review

Overview of acute type A dissection in Japan

Hiroaki Osada et al. Indian J Thorac Cardiovasc Surg. 2023 Dec.

Abstract

Acute type A aortic dissection is a relatively uncommon but devastating disease and usually requires emergency surgery. Based on the several database projects, a large amount of perioperative patient data has now been accumulated and is expected to be useful in clinical practice. Especially in Japan, the number of surgeries for acute type A aortic dissection has been gradually increasing recently, and the overall mortality rate has stabilized at less than 10%. One of the keys to further improvement in outcomes will be to improve the results of aortic root replacement. In addition, strategies need to be established for very elderly patients, comatose patients, and patients with malperfusion as preoperative conditions. The use of a relatively new device, the frozen elephant trunk, is also increasing and might be changing the surgical outcome. In this report, we describe the current status of acute type A aortic dissection in Japan, with reference to recent guidelines and literature.

Keywords: Acute type A aortic dissection; Database; Frozen elephant trunk; Japan.

PubMed Disclaimer

Conflict of interest statement

Conflict of interestK.M. serve as medical adviser for Japan Lifeline Co, Ltd.

Figures

Fig. 1
Fig. 1
Overall number of surgeries for ATAAD and mortality rate, from JATS survey data. The graphs were drawn with reference to refs. 20–41. Left axis: number of cases (bar graph); right axis: mortality rate (line graph)
Fig. 2
Fig. 2
The number of surgeries for ATAAD and mortality rate of each procedure, from JATS survey data. The graphs were drawn with reference to refs. 20–41. Left axis: number of cases (bar graph); right axis: mortality rate (line graph). ASC, ascending aorta replacement; ROOT, root replacement; ARCH, arch replacement; ROOT-ARCH, root to arch replacement
Fig. 3
Fig. 3
Exterior view of J Graft FROZENIX, courtesy of Japan Lifeline Co., Ltd. A Front view of the stented segment of J Graft FROZENIX. B Side view of J Graft FROZENIX, consisting of 2 parts of the non-stented segment and the stented segment. The outer graft part is a polyester woven Dacron graft, and inner stent part has a woven structure made of Nitinol wire, a super-elastic/shape-memory alloy. C, D The delivery system consists of 2 elements: the resin shaft and soft sheath
See this image and copyright information in PMC

References

    1. Hagan PG, Nienaber CA, Isselbacher EM, Bruckman D, Karavite DJ, Russman PL, et al. The International Registry of Acute Aortic Dissection (IRAD): new insights into an old disease. JAMA. 2000;283:897–903. doi: 10.1001/jama.283.7.897. - DOI - PubMed
    1. Melvinsdottir IH, Lund SH, Agnarsson BA, Sigvaldason K, Gudbjartsson T, Geirsson A. The incidence and mortality of acute thoracic aortic dissection: results from a whole nation study. Eur J Cardiothorac Surg. 2016;50:1111–1117. doi: 10.1093/ejcts/ezw235. - DOI - PubMed
    1. Isselbacher EM, Preventza O, Hamilton Black J, 3rd, Augoustides JG, Beck AW, Bolen MA, et al. 2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease: a report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. Circulation. 2022;146:e334–e482. doi: 10.1161/CIR.0000000000001106. - DOI - PMC - PubMed
    1. Malaisrie SC, Szeto WY, Halas M, Girardi LN, Coselli JS, Sundt TM, 3rd, et al. 2021 The American Association for Thoracic Surgery expert consensus document: surgical treatment of acute type A aortic dissection. J Thorac Cardiovasc Surg. 2021;162:735–58.e2. doi: 10.1016/j.jtcvs.2021.04.053. - DOI - PubMed
    1. Erbel R, Aboyans V, Boileau C, Bossone E, Bartolomeo RD, Eggebrecht H, et al. 2014 ESC guidelines on the diagnosis and treatment of aortic diseases: document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC) Eur Heart J. 2014;35:2873–926. doi: 10.1093/eurheartj/ehu281. - DOI - PubMed

LinkOut - more resources