![]() Please review the participating sites, investigators, and publications provided here, and contact the coordinating center with any questions. We are encouraged by the continued enthusiasm of patients and providers for this work, and are glad to have you here. Survival after endovascular therapy in patients with type B aortic dissection: a report from the International Registry of Acute Aortic Dissection (IRAD) JACC Cardiovasc Interv. The work performed by this collaborative has elucidated new information on aortic disease and informed guidelines. IRAD is poised to continue enrolling centers and patients in order to further our efforts to improve practice and gain knowledge regarding this devastating disease. All rights reserved.Projects focus on a range of topics, including timing of symptom onset, nuances of presentation and the impact on diagnosis, hemodynamic signs of aortic dissection, initial and chronic medical therapy, selection of diagnostic imaging, and best practices in surgical, endovascular, and medical management.įurthermore, working groups to identify new breakthroughs in diagnosis and treatment have been developed, including groups targeting: the genetic basis of aortic dissection surgical and endovascular approaches and how patients should be followed and informed about the disease process. 4.5 of patients deny any pain whatsoever and are found as incidental findings or through screening programs. Surgical/hybrid therapy, although associated with 2-fold hospital mortality, appears to be associated with better long-term outcomes in the management of type A acute aortic dissection in this setting.Ĭopyright © 2013 The American Association for Thoracic Surgery. The International Registry of Acute Aortic Dissection (IRAD), which is the largest single dataset on the subject, has sharp severe pain as the most common presenting complaint. Type A acute aortic dissection complicated by mesenteric malperfusion is a rare but ominous complication carrying a high risk of hospital mortality. The multicenter referral center study included 29 women with aortic dissection during pregnancy or less than 12 weeks post partum in IRAD from 1998 to 2018. ![]() 020) were predictors of mortality whereas surgical/hybrid management (OR, 0.1 P =. Design, setting, and participants: A cohort study, comprising data from the International Registry of Acute Aortic Dissection (IRAD) (February 1, 1998, to February 28, 2018). 1 There are several mechanisms for acute aortic regurgitation in type A. 1 The murmur of aortic regurgitation was present in 44 of type A dissections and 12 of type B dissections in the International Registry of Acute Aortic Dissection series. At multivariate analysis, male gender (odds ratio, 1.7 P =. However, pulse deficits were present in only 19 of type A dissection and 9 of type B dissection. In-hospital mortality of patients with mesenteric malperfusion receiving medical, endovascular, and surgical/hybrid therapy was 95.2%, 72.7%, and 41.7%, respectively (P <. METHODS AND RESULTS: We examined patients enrolled in the International Registry of Acute Aortic Dissection from 1996 to 2009. Overall in-hospital mortality was 63.2% and 23.8% in patients with and without mesenteric malperfusion, respectively (P <. They were less likely to undergo surgical/hybrid treatment (52.9% vs 87.9%) and more likely to receive only medical (30.9% vs 11.6%) or endovascular (16.2% vs 0.5%) management (P <. Patients with mesenteric malperfusion were more likely to be older and to have coma, cerebrovascular accident, spinal cord ischemia, acute renal failure, limb ischemia, and any pulse deficit. Mesenteric malperfusion was detected in 68 (3.7%) of 1809 patients with type A acute dissection. A mortality model was used to identify predictors of in-hospital mortality in patients with mesenteric malperfusion. Patients with type A acute dissection enrolled in the International Registry for Acute Dissection (IRAD) were evaluated to assess differences in clinical features, management, and in-hospital outcomes according to the presence/absence of mesenteric malperfusion. Context: Acute aortic dissection is a life-threatening medical emergency associated with high rates of morbidity and mortality. We sought to address this by analyzing the International Registry of Acute Aortic Dissection (IRAD) global registry database. Few data exist on clinical/imaging characteristics, management, and outcomes of patients with type A acute dissection and mesenteric malperfusion. The effects of medications on the outcome of aortic dissection remain poorly understood.
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