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The evolution of management of type B aortic dissection in a series of 100 consecutive cases in a tertiary center

2023Artigo científico Acesso aberto
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dc.contributor.authorLopes, Alice
dc.contributor.authorPedro, Luís M
dc.contributor.authorMelo, Ryan
dc.contributor.authorMoutinho, Mariana
dc.contributor.authorSobrinho, Gonçalo
dc.contributor.authorAmorim, Pedro
dc.contributor.authorSilvestre, Luís
dc.contributor.authorFernandes E Fernandes, Ruy
dc.contributor.authorMinistro, Augusto
dc.contributor.authorMartins, Carlos
dc.contributor.authorAlmeida, Ana G.
dc.contributor.authorNobre, Angelo
dc.contributor.authorPinto, Fausto J.
dc.contributor.authorFernandes E Fernandes, Jose
dc.date.accessioned2023-07-20T13:57:16Z
dc.date.available2023-07-20T13:57:16Z
dc.date.issued2023
dc.description© 2023 Published by Elsevier Espa˜na, S.L.U. on behalf of Sociedade Portuguesa de Cardiologia. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).pt_PT
dc.description.abstractIntroduction and objectives: Management of aortic dissection is rapidly evolving. The present study aims to assess paradigm shifts in type B aortic dissection (TBAD) treatment modalities and their outcomes according to clinical presentation and type of treatment. We also aim to assess the impact of endovascular technology in TBAD management in order to define organizational strategies to provide an integrated cardiovascular approach. Methods: We performed a retrospective review with descriptive analysis of the last 100 consecutive patients with TBAD admitted to the Vascular Surgery Department of Centro Hospitalar Universitário Lisboa Norte over a 16-year period. Results were stratified according to treatment modality and stage of the disease. The study was further divided into two time periods, 2003-2010 and 2011-2019, respectively before and after the introduction of a dedicated endovascular program for aortic dissections. Results: A total of 100 patients (83% male; mean age 60 years) were included, of whom 59 were admitted in the acute stage (50.8% with complicated dissections). The other 41 patients were admitted for chronic dissections, most of them for surgical treatment of aneurysmal degeneration. Temporal analysis demonstrated an increase in the number of patients operated for aortic dissection, mainly due to an increase in chronic patients (33.3% in 2003-2010 vs. 64.4% in 2011-2019) and a clear shift toward endovascular treatment from 2015 onward. Overall in-hospital mortality was 14% and was significantly higher in the chronic phase (acute 5.1% vs. chronic 26.8%; OR 5.30, 95% CI 1.71-16.39; p=0.003) and in patients with aneurysmal degeneration, regardless of the temporal phase. Only one death was recorded in the endovascular group. Conclusion: Management of TABD carried an overall mortality of 14% during a 16-year period, but the appropriate use of endovascular technology has substantially reduced in-hospital mortality.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationRev Port Cardiol. 2023 Jul;42(7):603-612pt_PT
dc.identifier.doi10.1016/j.repc.2022.11.006pt_PT
dc.identifier.eissn2174-2030
dc.identifier.issn0870-2551
dc.identifier.urihttp://hdl.handle.net/10451/58694
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.relation.publisherversionhttps://www.sciencedirect.com/journal/revista-portuguesa-de-cardiologiapt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/pt_PT
dc.subjectAortic dissectionpt_PT
dc.subjectComplicationspt_PT
dc.subjectDrug therapypt_PT
dc.subjectEndovascular procedurespt_PT
dc.subjectPost-dissection aneurysmpt_PT
dc.subjectSurgerypt_PT
dc.titleThe evolution of management of type B aortic dissection in a series of 100 consecutive cases in a tertiary centerpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage612pt_PT
oaire.citation.issue7pt_PT
oaire.citation.startPage603pt_PT
oaire.citation.titleRevista Portuguesa de Cardiologiapt_PT
oaire.citation.volume42pt_PT
person.familyNameLopes
person.familyNamePedro
person.familyNameGouveia e Melo
person.familyNameSobrinho
person.familyNameFernandes e Fernandes
person.familyNameAlmeida Ministro
person.familyNameAlmeida
person.familyNameLucas Pereira Nobre
person.familyNamePinto
person.familyNameFernandes e Fernandes
person.givenNameAlice
person.givenNameLuís
person.givenNameRyan
person.givenNameGonçalo
person.givenNameRuy
person.givenNameAugusto Manuel
person.givenNameAna Gomes de
person.givenNameAngelo Manuel
person.givenNameFausto J.
person.givenNameJose
person.identifier1308889
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person.identifier.ciencia-id0B14-1812-24DC
person.identifier.ciencia-id211B-B548-CE4E
person.identifier.ciencia-id3514-2431-1C78
person.identifier.ciencia-idB710-641D-77AD
person.identifier.ciencia-id1F12-4544-1A00
person.identifier.ciencia-id3610-3184-3042
person.identifier.ciencia-id6D1C-B056-A429
person.identifier.ciencia-idC311-AEDD-6DBB
person.identifier.orcid0000-0002-1957-7614
person.identifier.orcid0000-0003-4310-9324
person.identifier.orcid0000-0001-8327-6384
person.identifier.orcid0000-0003-1050-4715
person.identifier.orcid0000-0003-1619-8851
person.identifier.orcid0000-0003-4042-496X
person.identifier.orcid0000-0003-0360-4363
person.identifier.orcid0000-0002-8034-4529
person.identifier.orcid0000-0002-2144-0430
person.identifier.ridG-9363-2015
person.identifier.scopus-author-id57203041538
person.identifier.scopus-author-id7004454630
person.identifier.scopus-author-id8256157300
person.identifier.scopus-author-id39761284300
person.identifier.scopus-author-id55628683100
person.identifier.scopus-author-id7102740158
person.identifier.scopus-author-id6603638540
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
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