Acute aortic syndromes: Pathophysiology and management

Reviews in Cardiovascular Medicine

Volumn 9, Issue 2, 2008, Pages 111-124

  Alli, Oluseun ^a   Jacobs, Larry ^b   Amanullah, Aman M ^a  

^a ALBERT EINSTEIN MEDICAL CENTER   (United States)

^b LEHIGH VALLEY HOSPITAL   (United States)

Author keywords

Acute aortic syndromes; Antihypertensive therapy; Aortic dissection; Intimal flap; Ischemia

Indexed keywords

ACUTE AORTIC SYNDROME; AORTA DISSECTION; AORTA SURGERY; AORTOGRAPHY; ARTERIAL PRESSURE; ATHEROSCLEROTIC PLAQUE; CLINICAL FEATURE; CORONARY STENT; EMERGENCY WARD; FOLLOW UP; HEART LEFT VENTRICLE CONTRACTION; HUMAN; MORTALITY; NUCLEAR MAGNETIC RESONANCE IMAGING; PATHOPHYSIOLOGY; PULSE WAVE; REVIEW; SPIRAL COMPUTER ASSISTED TOMOGRAPHY; SURVIVAL RATE; TRANSESOPHAGEAL ECHOCARDIOGRAPHY;

ACUTE DISEASE; ANEURYSM, DISSECTING; AORTIC ANEURYSM; AORTIC DISEASES; DIAGNOSIS, DIFFERENTIAL; ELECTROCARDIOGRAPHY; FIBRINOLYTIC AGENTS; HUMANS; HYPERTENSION; MYOCARDIAL ISCHEMIA; SUBSTANCE-RELATED DISORDERS; SYNDROME; TUNICA INTIMA; VASCULAR SURGICAL PROCEDURES;

EID: 48749100609     PISSN: 15306550     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Review

References (101)

1. Beighton P, de Paepe A, Danks D, et al. International nosology of heritable disorders of connective tissue, Berlin 1986. Am J Med Genet. 1988;29:581-594.
2. De Paepe A, Devereux R, Dietz H, et al. Revised diagnostic criteria for the Marfan syndrome. Am J Med Genet. 1996;62:417-426.
3. Schatcher N, Perloff JK, Mulder DG. Aortic dissection in Noonan's syndrome (46XY Turner). Am J Cardiol. 1984;54:464-465.
4. Price WH, Wilson J. Dissection of the aorta in Turner's syndrome. J Med Genet. 1983;20:61-63.
5. Lindsay J Jr, Hurst JW. Clinical features and prognosis in dissecting aneurysms of the aorta: a re-appraisal. Circulation. 1967;35:880-888.
6. Leonard JC, Hasleton PS. Dissecting aortic aneurysms: a clinicopathological study. Q J Med. 1979;48:55-76.
7. Wilson SK, Hutchins GM. Aortic dissecting aneurysms: causative factors in 204 cases. Arch Pathol Lab Med. 1982;106:175-180.
8. Larson EW, Edwards WD. Risk factors for aortic dissection: a necropsy study of 161 cases. Am J Cardiol. 1984;53:849-855.
9. Januzzi J, Sabatine MS, Eagle KA, et al. Iatrogenic aortic dissection. Am J Cardiol. 2002;89:623-626.
10. von Kodolitsch Y, Simic O, Schwartz A, et al. Predictors of proximal aortic dissection at the time of aortic valve replacement. Circulation. 1999;100:II-287-II-294.
11. Pieters FAA, Widdershoven JW, Gerardy A-C, et al. Risk of aortic dissection after aortic valve replacement. Am J Cardiol. 1997;72:1043-1047.
12. Hainer JW, Hamilton GW. Aortic abnormalities in relapsing polychondritis: report of a case with dissecting aortic aneurysm. N Engl J Med. 1969;280:1166-1168.
13. Mitchet CJ, McKenna CH, Luthra HS, O'Fallon WM. Relapsing polychondritis: survival and predictive role of early disease manifestations. Ann Intern Med. 1986;104:74-78.
14. Slater EE, DeSanctis RW. The clinical recognition of dissecting aortic aneurysm. Am J Med. 1976;60:625-633.
15. Pumphrey CW, Fay T, Weir I. Aortic dissection during pregnancy. Br Heart J. 1986;55:106-108.
16. Schnitker MA, Bayer CA. Dissecting aneurysm of the aorta in young individuals, particularly in association with pregnancy: with report of a case. Ann Intern Med. 1944;20:486-511.
17. Pedowitz P, Perell A. Aneurysms complicated by pregnancy. I. Aneurysms of the aorta and its major branches. Am J Obstet Gynecol. 1957; 73:720-735.
18. Crawford ES, Svensson LG, Coselli JS, et al. Surgical treatment of aneurysm and/or dissection of the ascending aorta, transverse aortic arch, and ascending aorta and transverse aortic arch. Factors influencing survival in 717 patients. J Thorac Cardiovasc Surg. 1989;98:659-674.
19. DeBakey ME, McCollum CH, Crawford ES, et al. Dissection and dissecting aneurysms of the aorta: twenty-year follow-up of five hundred and twenty-seven patients treated surgically. Surgery. 1982;92:1118-1134.
20. KrÜkenberg E. Beiträgezur frage des aneurysma dissecans. Allg Path. 1920;67:329-351.
21. Gore I. Pathogenesis of dissecting aneurysm of aorta. Arch Path Lab Med. 1952;53:142-153.
22. Hirst AE Jr, Johns VJ Jr, Kime SW Jr. Dissecting aneurysm of the aorta: a review of 505 cases. Medicine. 1958;37:217-279.
23. Klotz O, Simpson W. Spontaneous rupture of aorta. Am J Med SC. 1932;184:455-473.
24. Stellwag-Carion C, Pollak S. [Idiopathic aortic rupture as a cause of sudden death.] Beitr Gerichtl Med. 1978;36:307-317.
25. Weintraub AR, Erbel R, Gorge G, et al. Intravascular ultrasound imaging in acute aortic dissection. J Am Coll Cardiol. 1994;24:495-503.
26. Alfonso F, Goicolea J, Aragoncillo P, et al. Diagnosis of aortic intramural hematoma by intravascular ultrasound imaging. Am J Cardiol. 1995;76:735-738.
27. Zotz R, Erbel R, Meyer J. Noncommunicating intrawall hematoma as an early sign of aortic dissection. J Am Soc Echocardiogr. 1991;4:636-638.
28. O'Gara PT, DeSanctis RW. Acute aortic dissection and its variants. Circulation. 1995;92:1376-1378.
29. Shimizu H, Yohino H, Udagawa H, et al. Prognosis of intramural hemorrhage compared with classic aortic dissection. Am J Cardiol. 2000;85:792-795.
30. Yamada T, Tada S, Harada J. Aortic dissection without intimal rupture: diagnosis with MR imaging and CT. Radiology. 1988;168:347-352.
31. Nienaber CA, von Kodolitsch Y, Petersen B, et al. Intramural hemorrhage of the thoracic aorta. Diagnostic and therapeutic implications. Circulation. 1995;92:1465-1472.
32. Stanson AV, Kazmier FJ, Hollier LH, et al. Penetrating atherosclerotic ulcers of the thoracic aorta: natural history and clinicopathologic correlations. Ann Vasc Surg. 1986;1:15-23.
33. Cooke JP, Kazmier FJ, Orszulak TA. The penetrating aortic ulcer: pathologic manifestations, diagnosis and management. Mayo Clin Proc. 1988;63:718-725.
34. Yucel EK, Steinberg FL, Egglin TK, et al. Penetrating aortic ulcers: diagnosis with MR imaging. Radiology. 1990;177:779-781.
35. Kazerooni EA, Bree RL, Williams DM. Penetrating atherosclerotic ulcers of the descending thoracic aorta: evaluation with CT and distinction from aortic dissection. Radiology. 1992,183:759-765.
36. Braverman AC. Penetrating atherosclerotic ulcers of the aorta. Curr Opin Cardiol. 1994;9:591-597.
37. Movsowitz HD, Lampert C, Jacobs LE, Kotler MN. Penetrating atherosclerotic aortic ulcers. Am Heart J. 1994;128:1210-1217.
38. Amnions MA, Moore EE, Moore FA, Hopeman AR. Intraaortic balloon pump for combined myocardial contusion and thoracic aortic rupture. J Trauma. 1990;30:1606-1608.
39. Moles VP, Chappuis F, Simonet F, et al. Aortic dissection as complication of percutaneous transluminal coronary angioplasty. Cathet Cardiovasc Diagn. 1992;26:811.
40. Erbel R, Bednarczyk I, Pop T, et al. Detection of dissection of the aortic intima and media after angioplasty of coarctation of the aorta. An angiographic, computer tomographic, and echocardiographic comparative study. Circulation. 1990;81:805-814.
41. Alfonso F, Almeria C, Fernandez-Ortiz A, et al. Aortic dissection occurring during coronary angioplasty: angiographic and transesophageal echocardiographic findings. Cathet Cardiovasc Diagn. 1997;42:412-415.
42. Anagnostopoulos CE. Acute Aortic Dissection. Baltimore, MD: University Park Press; 1975.
43. Asfoura JY, Vidt DG. Acute aortic dissection. Chest. 1991;99:724-729.
44. Fuster V, Halperin JL. Aortic dissection: a medical perspective. J Card Surg. 1994;9:713-728.
45. Shennan T. Dissecting Aneurysm. Medical Research Council Special Report Series, No 193. London, England: Her Majesty's Stationery Office; 1984.
46. Fowkes FG, Macintyre CC, Ruckley CV. Increasing incidence of aortic aneurysms in England and Wales. Br Med J. 1989;298:33-35.
47. Meszaros I, Morocz J, Szlavi J, et al. Epidemiology and clinicopathology of aortic dissection. Chest. 2000;117:1271-1278.
48. Hagan PG, Nienaber CA, Isselbacher EM, et al. The International Registry of Acute Aortic Dissection (IRAD): new insights into an old disease. JAMA. 2000;283:897-903.
49. Mehta RH, O'Gara PT, Bossone E, et al. Acute type A aortic dissection in the elderly: clinical characteristics, management, and outcomes in the current era. J Am Coll Cardiol. 2002;40:685-692.
50. von Kodolitsch Y, Schwartz AG, Nienaber CA. Clinical prediction of acute aortic dissection. Arch Intern Med. 2000;160:2977-2982.
51. Mehta RH, Suzuki T, Hagan PG, et al. Predicting death in patients with acute type A aortic dissection. Circulation. 2002;105:200-206.
52. Sarasin FP, Louis-Simonet M, Gaspoz JM, et al. Detecting acute thoracic aortic dissection in the emergency department: time constraints and choice of the optimal diagnostic test. Ann Emerg Med. 1996;28:278-288.
53. Nienaber CA, Eagle KA. Aortic dissection: new frontiers in diagnosis and management. Circulation. 2003;108:628-635.
54. DeSanctis RW, Doroghazi RM, Austen WG, et al. Aortic dissection. N Engl J Med. 1987;317: 1060-1067.
55. Mehta RH, Manfredini R, Hassan F, et al. Chronobiological patterns of acute aortic dissection. Circulation. 2002;106:1110-1115.
56. Svensson LG, Crawford ES. Aortic dissection and aortic aneurysm surgery: clinical observations, experimental investigations, and statistical analyses. Part II. Curr Probl Surg. 1992; 29:913-1057.
57. Slater EE. Aortic dissection: presentation and diagnosis. In: Doroghazi RM, Slater EE, eds. Aortic Dissection. New York, NY: McGraw-Hill; 1983:61-70.
58. Fann JI, Sarris GE, Mitchell RS, et al. Treatment of patients with aortic dissection presenting with peripheral vascular complications. Ann Surg. 1990;212:705-713.
59. Spittell PC, Spittell JA Jr, Joyce JW, et al. Clinical features and differential diagnosis of aortic dissection: experience with 236 cases (1980 through 1990). Mayo Clin Proc. 1993;68:642-651.
60. Eagle KA. Current management of aortic dissection-data from the International Registry for Aortic Dissection (IRAD). Eur Soc Cardiol. 1999;3278.
61. Kamp TJ, Goldschmidt-Clermont PJ, Brinker JA, Resar JR. Myocardial infarction, aortic dissection, and thrombolytic therapy. Am Heart J. 1994;128:1234-1237.
62. Hartnell GG, Wakeley CJ, Tottle A, et al. Limitations of chest radiography in discriminating between aortic dissection and myocardial infarction: implications for thrombolysis. J Thorac Imaging. 1993;8:152-155.
63. Erbel R, Alfonso F, Boileau C, et al. Diagnosis and management of aortic dissection: recommendations of the task force on aortic dissection, European Society of Cardiology. Eur Heart J. 2001;22:1642-1681.
64. Yamada E, Matsumura M, Kyo S, Omoto R. Usefulness of a prototype intravascular ultrasound imaging in evaluation of aortic dissection and comparison with angiographic study, transesophageal echocardiography, computed tomography, and magnetic resonance imaging. Am J Cardiol. 1995;75:161-165.
65. Erbel R, Oelert H, Meyer J, et al. Influence of medical and surgical therapy on aortic dissection evaluated by transesophageal echocardiography. Circulation. 1993;87:1604-1615.
66. Mohr-Kahaly S, Erbel R, Rennollet H, et al. Ambulatory follow-up of aortic dissection by transesophageal two-dimensional and color-coded Doppler echocardiography. Circulation. 1989;80:24-33.
67. Erbel R, Engberding R, Daniel W, et al. Echocardiography in diagnosis of aortic dissection. Lancet. 1989;1:457-461.
68. Erbel R, Mohr-Kahaly S, Oelert H, et al. Diagnostic strategies in suspected aortic dissection: comparison of computed tomography, aortography and transesophageal echocardiography. Am J Card Imaging. 1990;4:157-172.
69. Mintz GS, Kotler MN, Segal BL, Parry WR. Two-dimensional echocardiographic recognition of the descending thoracic aorta. Am J Cardiol. 1979;44:232-238.
70. Khandheria BK, Tajik AJ, Taylor CL, et al. Aortic dissection: review of value and limitations of two-dimensional echocardiography in a six-year experience. J Am Soc Echocardiogr. 1989;2: 17-24.
71. Iliceto S, Ettorre G, Francioso G, et al. Diagnosis of aneurysm of the thoracic aorta. Comparison between two non invasive techniques: two-dimensional echocardiography and computed tomography. Eur Heart J. 1984;5:545-555.
72. Sommer T, Fehske W, Holzknecht N, et al. Aortic dissection: a comparative study of diagnosis with spiral CT, multiplanar transesophageal echocardiography, and MR imaging. Radiology. 1996;199:347-352.
73. Nienaber CA, von Kodolitsch Y, Nicolas V, et al. The diagnosis of thoracic aortic dissection by noninvasive imaging procedures. N Engl J Med. 1993;328:1-9.
74. Nienaber CA, von Kodolitsch Y. [Diagnostic imaging of aortic diseases]. Radiologe. 1997;37:402-409.
75. Kersting-Sommerhoff BA, Higgins CB, White RD, et al. Aortic dissection: sensitivity and specificity of MR imaging. Radiology. 1988; 166:651-655.
76. Deutsch HJ, Sechtem U, Meyer H, et al. Chronic aortic dissection: comparison of MR imaging and transesophageal echocardiography. Radiology. 1994;192:645-650.
77. Pelc NJ, Herfkens RJ, Shimakawa A, Enzmann DR. Phase contrast cine magnetic resonance imaging. Magn Reson Q. 1991;7:229-254.
78. Honda T, Hamada M, Matsumoto Y, et al. Diagnosis of thrombus and blood flow in aortic aneurysm using tagging cine magnetic resonance imaging. Int J Angiol. 1999;8:57-61.
79. Robb GP, Steinberg I. Visualization of chambers of heart, pulmonary circulation and great blood vessels in man: a practical method. Am J Roentgenol. 1939;41:1-17.
80. Dinsmore RE, Rourke JA, DeSanctis RW, et al. Angiographic findings in dissecting aortic aneurysm. N Engl J Med. 1966;275:1152-1157.
81. Shuford WH, Sybers RG, Weens HS. Problems in the aortographic diagnosis of dissecting aneurysms of the aorta. Engl J Med. 1969; 280:225-231.
82. Sanders C. Current role of conventional and digital aortography in the diagnosis of aortic disease. J Thorac Imaging. 1990;5:48-59.
83. Khandheria BK. Aortic dissection: the last frontier. Circulation. 1993;87:1765-1768.
84. Bansal RC, Chandrasekaran K, Ayala K, Smith DC. Frequency and explanation of false negative diagnosis of aortic dissection by aortography and transesophageal echocardiography. J Am Coll Cardiol. 1995;25:1393-1401.
85. Gott VL, Cameron DE, Pyeritz RE, et al. Composite graft repair of Marfan aneurysm of the ascending aorta: results in 150 patients. J Card Surg. 1994;9:482-489.
86. Kouchoukos NT, Wareing TH, Murphy SF, Perrillo JB. Sixteen-year experience with aortic root replacement. Results in 172 operations. Ann Surg. 1991;214:308-320.
87. Borst HG, Walterbusch G, Schaps D. Extensive aortic replacement using "elephant trunk" prosthesis. Thorac Cardiovasc Surg. 1983;31:37-40.
88. Borst HG, Frank G, Schaps D. Treatment of extensive aortic aneurysms by a new multiple-stage approach. J Thorac Cardiovasc Surg. 1988;95:11-13.
89. Dake MD, Miller DC, Semba CP, et al. Transluminal placement of endovascular stent grafts for the treatment of descending thoracic aortic aneurysms. N Engl J Med. 1994;331:1729-1734.
90. Slonim SM, Nyman UR, Semba CP, et al. True lumen obliteration in complicated aortic dissection: endovascular treatment. Radiology. 1996;201:161-166.
91. Dake MD, Miller DC, Mitchell RS, et al. The "first generation" of endovascular stent-grafts for patients with aneurysms of the descending thoracic aorta. J Thorac Cardiovasc Surg. 1998;116:689-704.
92. Nienaber CA, Fattori R, Lund G, et al. Nonsurgical reconstruction of thoracic aortic dissection by stent-graft placement. N Engl J Med. 1999;340:1539-1545.
93. Inoue K, Sato M, Iwase T, et al. Clinical endovascular placement of branched graft for type B aortic dissection. J Thorac Cardiovasc Surg. 1996;112:1111-1113.
94. Walker PJ, Dake MD, Mitchell RS, Miller DC. The use of endovascular techniques for the treatment of complications of aortic dissection. J Vasc Surg. 1993,18:1042-1051.
95. Williams DM, Lee DY, Hamilton BH, et al. The dissected aorta: percutaneous treatment of ischemic complications-principles and results. J Vasc Interv Radiol. 1997;8:605-625.
96. Lee DY, Williams DM, Abrams GD. The dissected aorta: part II. Differentiation of the true from the false lumen with intravascular US. Radiology. 1997;203:32-36.
97. Slonim SM, Nyman U, Semba CP, et al. Aortic dissection: percutaneous management of ischemic complications with endovascular stents and balloon fenestration. J Vasc Surg. 1996; 23:241-253.
98. Murray JW, Mann JJ, Genecin A, McKusick VA. Fever with dissecting aneurysm of the aorta. Am J Med. 1976;61:140-144.
99. Reul GJ, Cooley DA, Hallman GL, et al. Dissecting aneurysm of the descending aorta. Arch Surg. 1975;110:632-640.
100. Glower DD, Speier RH, White WD, et al. Management and long-term outcome of aortic dissection. Ann Surg. 1991;214:31-41.
101. Braunwald E, Zipes DP, Libby P, Bonow R. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 7th ed. Philadelphia, PA: WB Saunders; 2004.