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Clinical profiles and outcomes of acute type A aortic dissection and intramural hematoma in the current era: lessons from the first registry of aortic dissection in China

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Chinese Medical Journal 2021年第8期134卷 927-934页

作者： Wei-Xun Duan Wei-Guang Wang Lin Xia Chao Xue Bo Yu Kai Ren Wei Yi Hong-Liang Liang Xiao-Chao Dong Jian Zuo Jin-Cheng Liu Shi-Qiang Yu Ding-Hua Yi Departm ent of Cardiovascular Surgery Xijing Hospitalthe Fourth Military Medical UniversityXi'anShaanxi 710032China 71901 troops The Chinese People's Liberation ArmyLiaochengShandong 252000China

Background::acute type A aortic dissection(ATAAD)and acute type a intramural hematoma(ATAIMH)are life-threatening diseases with high *** better understand their clinical features in the Chinese population,we analyzed the data from the first Registry of Aortic Dissection in China(Sino-RAD)to promote the understanding and management of the ***::All patients with ATAAD and ATAIMH enrolled in Sino-RAD from January 1,2012 to December 31,2016 were *** data of patients’selection,history,symptoms,management,outcomes,and postoperation complications were analyzed in the *** continuous variables were compared using the Student’s t test for normal distributions and the Mann-Whitney U test for non-normal *** variables were compared using the Chi-square test or Fisher exact ***::A total of 1582 patients with ATAAD and 130 patients with ATAIMH were *** mean age of all patients was 48.4 *** with ATAAD were significantly younger than patients with ATAIMH(48.9 years vs.55.6 years,P<0.001).For the total cohort,males were dominant,but the male ratio of patients with ATAAD was significantly higher compared to those with ATAIMH(P=0.01).The time range from the onset of symptom to hospitalization was 2.0 *** patients of ATAIMH had hypertension than that of ATAAD(82.3%vs.67.6%,P<0.05).Chest and back pain were the most common clinical *** tomography(CT)was the most common initial diagnostic imaging modality.84.7%received surgical treatment and in-hospital mortality was 5.3%.Patients with ATAAD mainly received surgical treatment(89.6%),while most patients with ATAIMH received medical treatment(39.2%)or endovascular repair(35.4%).Conclusions::Our study suggests that doctors should comprehensively use clinical examination and genetic background screening for patients with ATAAD and ATAIMH and further shorten the time range from symptoms onset to intervention,achieving early diagnosis

关键词： Aortic dissection acute type A aortic dissection acute type a intramural hematoma

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