Current review of acute type A aortic dissection in Malaysia

IF 0.7 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Indian Journal of Thoracic and Cardiovascular Surgery Pub Date : 2023-11-14 DOI:10.1007/s12055-023-01608-2

Paneer Selvam Krishna Moorthy, Abdul Samad Sakijan, Deventhiran Permal, Intan Fariza Gaaffar, Aini Syakirin Kepli, Haidatul Insyirah Sahimi

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引用次数: 0

Abstract

Abstract Acute type A aortic dissection (ATAAD) still poses significant challenges and management dilemmas for cardiovascular surgeons worldwide. Despite the continuous improvement in diagnosis and management strategies for ATAAD, clinical outcomes remain poor and the optimal therapy is still debatable especially those with malperfusion syndrome (MPS). This review is based on the current literature and includes the results from the Aortic Registry of National Heart Institute of Malaysia (NHIM) database. It covers different aspects of ATAAD and concentrates on the outcome of surgical repair. The diagnosis is often delayed leading to variable outcomes. High index of suspicion and urgent treatment is required to tackle this dynamic disease which include the variation in presentation and clinical course. Different surgical techniques and perfusion strategies have been described to save patients. Complex techniques such as total arch replacement (TAR) with frozen elephant trunk and valve sparing root surgery may provide long-term benefit in selected patients, but require significant surgical expertise and experience.

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马来西亚急性A型主动脉夹层的现状综述

急性A型主动脉夹层(ATAAD)仍然是全世界心血管外科医生面临的重大挑战和管理难题。尽管ATAAD的诊断和治疗策略不断改进，但临床结果仍然很差，最佳治疗方法仍然存在争议，特别是对于灌注不良综合征(MPS)。这篇综述是基于目前的文献，包括来自马来西亚国立心脏研究所(NHIM)数据库的主动脉登记结果。它涵盖了ATAAD的不同方面，并集中于手术修复的结果。诊断常常延迟，导致不同的结果。需要高度的怀疑和紧急治疗，以解决这一动态疾病，其中包括变化的表现和临床过程。不同的手术技术和灌注策略已经描述，以挽救病人。复杂的技术，如全弓置换术(TAR)与冷冻象鼻和保留根瓣膜手术可能为选定的患者提供长期的益处，但需要大量的外科专业知识和经验。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Indian Journal of Thoracic and Cardiovascular Surgery CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

1.20

自引率

14.30%

发文量

141

期刊介绍： The primary aim of the Indian Journal of Thoracic and Cardiovascular Surgery is education. The journal aims to dissipate current clinical practices and developments in the area of cardiovascular and thoracic surgery. This includes information on cardiovascular epidemiology, aetiopathogenesis, clinical manifestation etc. The journal accepts manuscripts from cardiovascular anaesthesia, cardiothoracic and vascular nursing and technology development and new/innovative products.The journal is the official publication of the Indian Association of Cardiovascular and Thoracic Surgeons which has a membership of over 1000 at present.DescriptionThe journal is the official organ of the Indian Association of Cardiovascular-Thoracic Surgeons. It was started in 1982 by Dr. Solomon Victor and ws being published twice a year up to 1996. From 2000 the editorial office moved to Delhi. From 2001 the journal was extended to quarterly and subsequently four issues annually have been printed out at time and regularly without fail. The journal receives manuscripts from members and non-members and cardiovascular surgeons. The manuscripts are peer reviewed by at least two or sometimes three or four reviewers who are on the panel. The manuscript process is now completely online. Funding the journal comes partially from the organization and from revenue generated by subscription and advertisement.