التفاصيل البيبلوغرافية
| العنوان: |
Prognostic role of transesophageal echocardiography in acute type A aortic dissection. |
| المؤلفون: |
Bossone, Eduardo, Evangelista, Arturo, Isselbacher, Eric, Trimarchi, Santi, Hutchison, Stuart, Gilon, Dan, Llovet, Alfredo, O'Gara, Patrick, Cooper, Jeanna V., Fang, Jianming, Januzzi, James L., Mehta, Rajendra H., Distante, Alessandro, Nienaber, Christoph A., Eagle, Kim, Armstrong, William F., International Registry of Acute Aortic Dissection Investigators |
| المصدر: |
American Heart Journal; Jun2007, Vol. 153 Issue 6, p1013-1020, 8p |
| مصطلحات موضوعية: |
ECHOCARDIOGRAPHY, DIAGNOSTIC ultrasonic imaging, CARDIAC imaging, AORTIC dissection, AORTIC aneurysm treatment, HYPERTENSION epidemiology, AORTIC aneurysms, COMPARATIVE studies, DEMOGRAPHY, MARFAN syndrome, VASCULAR resistance, RESEARCH methodology, MEDICAL cooperation, PROGNOSIS, RESEARCH, RISK assessment, SURVIVAL analysis (Biometry), TRANSESOPHAGEAL echocardiography, COMORBIDITY, LOGISTIC regression analysis, EVALUATION research, HOSPITAL mortality, DISSECTING aneurysms, THERAPEUTICS |
| مستخلص: |
Background: Acute type A aortic dissection (AAD) remains a highly lethal entity for which emergent surgical correction is standard care. Prior studies have identified specific clinical findings as being predictive of outcome. The prognostic significance of specific findings on imaging studies is less well described. We sought to identify the prognostic value of transesophageal echocardiography (TEE) in medically and surgically treated patients with AAD. Methods: We studied 522 AAD patients enrolled over 6 years in the International Registry of Acute Aortic Dissection who underwent TEE. Multivariate analysis identified independent associations of inhospital mortality, first using clinical variables (model 1), after which TEE data were added to build a final model (model 2). Results: Inhospital mortality was 28.7%. Transesophageal echocardiographic evidences of pericardial effusion (P = .04), tamponade (P < .01), periaortic hematoma (P = .02), and patent false lumen (P = .08) were more frequent in nonsurvivors. Dilated ascending aorta (P = .03), dissection localized to the ascending aorta (P = .02), and thrombosed false lumen (P = .08) were less common in nonsurvivors. Model 1 identified age > or = 70 years, any pulse deficit, renal failure, and hypotension/shock as independent predictors of death. Model 2 identified dissection flap confined to ascending aorta (odds ratio 0.2, 95% CI 0.1-0.6) and complete thrombosis of false lumen (odds ratio 0.15, 95% CI 0.03-0.86) as protective. In the medically treated group, mortality was 31% for subjects with a partially or completely thrombosed false lumen versus 66% in the presence of a patent false lumen. Conclusions: Transesophageal echocardiography provides prognostic information in AAD beyond that provided by clinical risk variables. [ABSTRACT FROM AUTHOR] |
|
Copyright of American Heart Journal is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| قاعدة البيانات: |
Supplemental Index |
