Características de los pacientes con disección aórtica aguda en Villa Clara: Estudio multicéntrico

Daniel A. Vera Rivero; Yamir Santos Monzón; Marli Gamito González; Carlos M. Aguiar Mota

Authors

Daniel A. Vera Rivero
Yamir Santos Monzón
Marli Gamito González
Carlos M. Aguiar Mota

Abstract

Introduction: Acute aortic dissection is considered one of the most tragic cardiovascular diseases that occur in humans; with high mortality which requires early diagnosis and treatment.

Objectives: To describe the characteristics of patients with aortic dissection treated in 4 hospital institutions in the province of Villa Clara.

Method: An observational, descriptive, cross-sectional, multicenter study was conducted in 25 patients who were treated under the diagnosis of aortic dissection in the period between January 2012 and December 2017, in 4 secondary-level hospital centers in Villa Clara province, Cuba.

Results: The mean age of the patients was 60.48 ± 13.99 years, 21 were male, which represented 84.0%. According to the Stanford classification, type A predominated in 17 patients (68.0%). The most common symptom was anterior chest pain while the most frequent complication was cardiac tamponade (28.0%).

Conclusions: The characteristics of patients with aortic dissection in the Villa Clara setting manifested in a similar way to those in the national and international sphere. A high level of suspicion is required by the doctor to achieve a timely diagnosis and treatment.

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References

1. Ros-Díe E, Fernández-Quesada F, Ros-Vidal R, Salmerón-Febres LM, Linares-Palomino JP, Sellés-Galiana F. Historia natural de la diseccion aórtica. Angiología. 2006;58(Supl 1):59-67.

2. Carbonell Cantí C. Historia de la cirugía de la aorta torácica. En: Vaquero C, ed. Cirugía de la aorta torácica. Valladolid: Gráficas Andrés Martín SL; 2010. p. 15-32.

3. Erbel R, Aboyans V, Boileau C, Bossone E, Di Bartolomeo R, Eggebrecht H, et al. Guía ESC 2014 sobre diagnóstico y tratamiento de la patología de la aorta. Rev Esp Cardiol. 2015;68(3):242.e1-e69.

4. Davies RR, Goldstein LJ, Coady MA, Tittle SL, Rizzo JA, Kopf GS, et al. Yearly rupture or dissection rates for thoracic aortic aneurysms: Simple prediction based on size. Ann Thorac Surg. 2002;73(1):17-27.

5. 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(7):897-903.

6. Howard DP, Banerjee A, Fairhead JF, Perkins J, Silver LE, Rothwell PM, et al. Population-based study of incidence and outcome of acute aortic dissection and premorbid risk factor control: 10-year results from the Oxford Vascular Study. Circulation. 2013;127(20):2031-7.

7. Tsai TT, Trimarchi S, Neinaber CA. Acute aortic dissection: Perspectives from the International Registry of Acute Aortic Dissection (IRAD). Eur J Vasc Endovasc Surg. 2009;37(2):149-59.

8. Nienaber CA, Fattori R, Mehta RH, Richartz BM, Evangelista A, Petzsch M, et al. Gender-related differences in acute aortic dissection. Circulation. 2004;109(24):3014-21.

9. Monzó Blasco A, Alpañez Carrascosa N, Salvador Martínez MC, Sancho Jiménez J, Amorós Comes D, Casado de Amezúa AC, et al. Muerte súbita por disección aórtica. CorSalud [Internet]. 2017 [citado 16 Oct 2018];9(4):229-35. Disponible en: http://www.revcorsalud.sld.cu/index.php/cors/article/view/265/549

10. Di Eusanio M, Trimarchi S, Patel HJ, Hutchison S, Suzuki T, Peterson MD, et al. Clinical presentation, management, and short-term outcome of patients with type A acute dissection complicated by mesenteric malperfusion: observations from the International Registry of Acute Aortic Dissection. J Thorac Cardiovasc Surg. 2013;145(2):385-90.

11. Braverman AC. Diseases of the aorta. En: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10 ed. Philadelphia: Elsevier Saunders; 2015. p. 1210-69.

12. Sparks SE, Kurz M, Franzen D. Early identification of an atypical case of type A dissection by transthoracic echocardiography by the emergency physician. Am J Emerg Med. 2015;33(7):985.e1-3.

13. Romero Cabrera ÁJ, Olivert Cruz M, Bermúdez López J. Disección aórtica aguda: serie cronológica (1987-2007). Finlay [Internet]. 2011 [citado 20 Oct 2018];1(2): 75-80. Disponible en: http://www.revfinlay.sld.cu/index.php/finlay/article/view/36/1348

14. Higa C, Guetta J, Borracci RA, Meribilhaa R, Marturano MP, Marenchino R, et al. Registro multicéntrico de disección aórtica aguda. Estudio RADAR. Resultados preliminares. Rev Argent Cardiol. 2009;77(5):354-60.

15. Evangelista A, Padilla F, López-Ayerbe J, Calvo F, López-Pérez JM, Sánchez V, et al. Registro Español del Síndrome Aórtico Agudo (RESA). La mejora en el diagnostico no se refleja en la reducción de la mortalidad. Rev Esp Cardiol. 2009;62(3):255-62.

16. Valencia Guadalajara MC, Hernández González A, Jiménez Aragón F, Quintana de la Cruz RM. Ictus como presentación tardía de extensa disección aórtica. Neurol Arg. 2018;10(1):63-4.

17. Valdés Dupeyrón O, Hurtado de Mendoza Amat J, Montero González TJ, Álvarez Santana R, Arazoza Hernández A, Chao García JL. Comportamiento de la mortalidad por disección aórtica en Cuba. CorSalud [Internet]. 2014 [citado 21 Oct 2018];6(2):140-7. Disponible en: http://www.revcorsalud.sld.cu/index.php/cors/article/view/153/395

18. Hu G, Jin B, Zheng H, Lai C, Ouyang C, Xia Y, et al. Analysis of 287 patients with aortic dissection: General characteristics, outcomes and risk factors in a single center. J Huazhong Univ Sci Technolog Med Sci. 2011;31(1):107-13.

19. Pape LA, Awais M, Woznicki EM, Suzuki T, Trimarchi S, Evangelista A, et al. Presentation, diagnosis, and outcomes of acute aortic dissection: 17-year trends from the International Registry of Acute Aortic Dissection. J Am Coll Cardiol. 2015; 66(4):350-8.

20. Gilon D, Mehta RH, Oh JK, Januzzi JL, Bossone E, Cooper JV, et al: Characteristics and in-hospital outcomes of patients with cardiac tamponade complicating type A acute aortic dissection. Am J Cardiol. 2009;103(7):1029-31.