Impact of aortic regurgitation on the prognosis of patients with type A acute aortic syndrome.
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Le résumé fourni par la source
Abstract Introduction Aortic regurgitation (AR) is a common complication of type A acute aortic syndrome (AAS-A). The management of patients with AR in this context is controversial and depends largely on the mechanism of the AR, the haemodynamic stability and the surgical team experience. The aim of the study is to describe clinical profile of AAS patients with significant AR, as well as its mechanism, prognostic impact and treatment. Methods From 2019 to 2024, patients admitted for AAS-A in a tertiary care hospital were prospectively and consecutively collected. They were classified in three groups according to the presence of AR: no/mild, moderate and severe. Clinical, analytical, echocardiographic, surgical and prognostic variables were analysed. Surgical risk was estimated using the GERAADA risk scale. Results There were 126 patients with AAS-A, most of whom presented significant AR(Table). Root dilatation (73.33%) and tearing of the sinuses of Valsalva were the main AR mechanisms. In contrast, in the moderate AR group, the second cause was the presence of previous valve disease. Clinical presentation (Table) and time to diagnosis were similar: median 4.8h (IQR 1.6-11.6) in mild AR vs 3.3h (IQR 1.6-6.7) in at least moderate AR, p=0.240. At surgery, patients with significant AR required prosthesis implantation to a greater extent (Table), with no differences in the type (biological/mechanical). Time to surgery was similar between groups 1.47h, (IQR CI 0.33-2.45) in non-significant AR vs 1.78h (IQR 2.54-3.01) in significant AR, p= 0.779. There were no differences in postoperative in hospital evolution and 30-day mortality between groups (figure). A multivariate analysis was performed including significant AR and variables of known prognostic impact (age, tamponade, myocardial infarction, shock, need for intubation). Significant AR was not independently associated with increased mortality (OR=1 IQR 0.2-3.9, p= 0.98). Only the presence of preoperative shock was independently associated with a higher 30-day mortality (OR= 6.09 IQR 1.4-24.9, p= 0.012). Conclusion AR is a frequent complication in A-AAS patients. The most common mechanism is dilatation and distortion of the aortic root. Most patients were managed with aortic root repair. The presence of AR was not associated with a higher incidence of complications or 30-day mortality.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Impact of aortic regurgitation on the prognosis of patients with type A acute aortic syndrome.
- Date Crossref
- 01/04/2025
- Éditeur
- Oxford University Press (OUP)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Hospital Clínico San Carlos pays non établi dans la noticeÉtablissement de santé
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Hospital Universitario Príncipe de Asturias pays non établi dans la noticeÉtablissement de santé
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Hospital Universitario de Fuenlabrada pays non établi dans la noticeÉtablissement de santé
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Hospital Universitario Severo Ochoa pays non établi dans la noticeÉtablissement de santé
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San Carlos Clinical Hospital pays non établi dans la noticeÉtablissement de santé
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Hospital Universitario Principe Asturias pays non établi dans la noticeÉtablissement de santé
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SUMMA 112 pays non établi dans la noticeInstitution
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University Hospital of Fuenlabrada pays non établi dans la noticeUniversité ou école supérieure
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Severo Ochoa Hospital pays non établi dans la noticeÉtablissement de santé
Hospital Clínico San Carlos, Hospital Universitario Príncipe de Asturias et Hospital Universitario de Fuenlabrada, avec 6 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.