Navigation Links
Aortic Dissection - A Deadly Condition

Actor John Ritter died of a lethal condition called aortic dissection (a tear in the largest blood vessel in the body) around three years ago//. His death brought the focus on this deadly disease, which is associated with high blood pressure and genetic disorders.

Now, researchers have published some rare good news about aortic dissection, showing that 90 percent of patients who survive emergency surgery and hospitalization for its most serious form will still be alive three years later. Those without pre-existing heart and blood vessel problems were even more likely to survive. The findings are published in a supplement to the journal Circulation.

The study, performed by an international team led by specialists at the University of Michigan Cardiovascular Center, involved data from 303 patients. All were treated in the late 1990s and early 2000s for the most serious form of aortic dissection, called Type A, which occurs in the upper part of the aorta near the heart.

It's a unique study looking at survival among Type A aortic dissection patients who live through their initial crisis. The authors say the results offer hope that with proper rapid diagnosis and successful surgery, more patients can survive.

However, because aortic dissection is rare and its symptoms can mimic those of a heart attack, it is often not diagnosed or treated quickly -- contributing to a 30 percent in-hospital death rate that includes a 25 percent risk of death during surgery. But less is known about the fate of those who survive long enough to leave the hospital.

"Clearly, this is one of those diseases where if you catch it early you can save lives in the hospital, and with successful surgery your outlook after discharge can look quite good," says lead author Thomas Tsai, M.D., a cardiovascular research fellow at the U-M Medical School. "Of course, those who do survive will have a diagnosis for life of aortic disease, and will need medi cation and aggressive monitoring of their aorta."

Tsai and senior author Kim Eagle, M.D., co-director of the U-M CVC, conducted the research with colleagues from the International Registry of Aortic Dissection, or IRAD, using data on patients treated at 21 medical centers in 11 countries. U-M is the coordinating center for IRAD.

"Aortic dissection is still very much a lethal health crisis, with mortality approaching 2 percent per hour. But these results show we're doing a pretty good job in helping patients after they weather the storm of diagnosis and surgery," says Eagle.

The new study drew its patients from a group of 885 Type A aortic dissection patients who came or were transferred to IRAD centers. Nearly 30 percent of the Type A patients died before leaving the hospital, and long-term follow-up data were available on many of the 617 who left the hospital after surgical or non-surgical treatment. The patients included in the final analysis were treated at eight IRAD centers that compiled long-term follow-up data on most of their patients.

Ninety percent of the 303 patients in the study had surgery; the rest received medical treatment because of advanced age, pre-existing conditions that made surgery too risky, or patients' refusal to have surgery. Death rates were much higher among the non-surgical patients. The average age of all the patients was 59, but a quarter of the patients were over age 70 -- reflecting the fact that aortic dissection can strike relatively young patients with genetic diseases such as Marfan syndrome that prematurely weaken the walls of their aorta, or can arise from a lifetime of high blood pressure that stresses the aorta and creates weak spots.

Seventy-two percent of the patients in the study had hypertension before their dissection. Nearly 25 percent had atherosclerosis (clogged, stiffened blood vessels often linked to high cholesterol and blood pressure) and just under 13 per cent had had some sort of cardiovascular surgery in the past.

These underlying problems -- and not any aspect of their in-hospital complications -- appear to have made a big impact on patients' risk of dying after leaving the hospital. In fact, patients who had atherosclerosis or previous cardiovascular surgery had twice the risk of dying in the three-year follow-up period as patients without these characteristics. "What predicts an aortic dissection patient's death after hospitalization are the risk factors they came in with," says Tsai.

Tsai and Eagle note that the good news of the new result may have a lot to do with recent advances in emergency diagnosis, surgical and anesthesiology techniques, and intensive-care practices, as well as better post-hospital care of patients using drugs and regular medical imaging. Because IRAD has collected data on so many patients treated within a seven-year period, the authors say, the study reflects the modern treatment of the condition, compared with other studies that have compiled data from patients treated over several decades at one or two medical centers.

Now, the researchers are hopeful that early diagnosis and rapid treatment will increase as more hospitals use advanced medical imaging to determine what is causing chest pain in patients who come to emergency rooms. Advanced CT scanners, for example, can make a "triple rule-out" scan that can quickly tell if a patient is experiencing a heart attack, an aortic dissection, or a blood clot in the lung. But, says Tsai, doctors need to order the right kind of scan or a dissection can be missed.

A "swat team" approach that combines the talents of emergency room doctors and nurses, cardiologists, radiologists, surgeons and anesthesiologists to make rapid diagnostic and treatment decisions may also help, says Eagle. Such an approach is now in place at the U-M Health System.

The IRAD team is also working to improve the screen ing tools that might be used to determine who is at high risk of an aortic dissection. Currently, people with Marfan syndrome, connective tissue disorders and some other conditions are known to have an elevated risk, as are people with long-term blood pressure problems. It can also occur during pregnancy or childbirth, or in cocaine users.

IRAD researchers are currently developing tests that would examine DNA or blood to screen high-risk people or the relatives of dissection patients, to make a rapid diagnosis in the emergency room, or to add to long-term monitoring of survivors. Better screening for aneurysms in the aorta, which are involved in a large percentage of dissections, could also help nip more dissections in the bud.

Contact: Kara Gavin kegavin@umich.edu 734-764-2220 University of Michigan Health System Source: Eurekalert
'"/>




Related medicine news :

1. Statins Not Effective In Treating Calcific Aortic Stenosis
2. New Way To Combat Spinal Cord Injury during Aortic Surgery
3. Enzyme Critical for Early Growth of Abdominal Aortic Aneurysms
4. Screening for Abdominal Aortic Aneurysms Saves Mens Lives
5. Smoking and Breast Cancer - A Deadly Combination
6. Latest Findings On The Deadly Disease - SARS
7. Deadly Diarrhoea Vaccine – Trail Results Promising
8. Sharp Increase Of The Deadly Diseases In Delhi
9. Imported Plants Could Deadly Harbor Mosquitoes, Says Report
10. Deadly Kiss - Peanut allergy kills a teenager
11. Deadly abortion pill takes two more lives
Post Your Comments:
*Name:
*Comment:
*Email:


(Date:2/11/2016)... ... February 11, 2016 , ... Thermi™, a ... is pleased to announce the promotions of Allison Kelly to executive vice president ... to executive vice president of North American capital sales, and Wendy Oseas to ...
(Date:2/11/2016)... , ... February 11, 2016 , ... ... motivational speaker, trainer and author Ray Clarke poses a question as a challenge ... . In his book, "Being in the Being" (published by Partridge Singapore), Clarke ...
(Date:2/11/2016)... ... February 11, 2016 , ... AccuVein Inc. announces ... Therapy Standards of Practice, to include vascular visualization as a standard practice. AccuVein ... share of the market, facilitates adherence to this standard with its easy to ...
(Date:2/11/2016)... ... February 11, 2016 , ... Pixel Film Studios brings the spirit of ... in the Christmas edition of the ProDrop series. Pick and choose from 30 unique ... the spirit of Christmas using ProDrop's wintry generators. ProDrop Christmas is a Final Cut ...
(Date:2/11/2016)... ... February 11, 2016 , ... Food Labeling for American ... and wellness best practices in the past couple of decades, and food manufacturers ... Heart Month, which acts as an exceptional opportunity to revise food labels and ...
Breaking Medicine News(10 mins):
(Date:2/11/2016)... , Feb. 11, 2016 Potrero Medical, Inc., ... pleased to announce the appointment of George M. Rapier, ... San Antonio, TX , WellMed is one of ... 200,000 patients and HMO members in Texas ... in 1990 out of his own internal medicine practice, he ...
(Date:2/11/2016)... , Feb. 11, 2016  NOIT™ Research LLC, a ... "Gift of Change" campaign to assist needy families in ... such unit sold between February 10, 2016 and March ... a needy family. The NOIT is an auditory stimulus ... individuals develop language skills. Beth Shier ...
(Date:2/11/2016)... , Feb. 11, 2016  MiMedx Group, Inc. ... utilizing human amniotic membrane and other birth tissues, human ... to develop and market advanced products and therapies, announced ... Markets, 2016 Global Healthcare Conference in New ... and CEO, Michael J. Senken , Chief Financial ...
Breaking Medicine Technology: