AORTIC DISSECTION: DIAGNOSTIC AND THERAPEUTIC STRATEGIES - A LITERATURE REVIEW

Authors

DOI:

https://doi.org/10.47820/recima21.v5i3.4963

Keywords:

Aortic dissection. Diagnosis. Treatment. Management and Multidisciplinary.

Abstract

Aortic dissection is a medical emergency with high mortality, requiring early diagnosis and immediate intervention. Advanced imaging methods and pharmacological therapies have revolutionized the management of the disease. Objective: To conduct a comprehensive literature review of the diagnostic and therapeutic strategies employed in aortic dissection. Methods: Original studies and reviews published in the last 15 years, with specific inclusion criteria, were selected and several electronic databases were searched. Results and Discussion: Advances in diagnosis, such as CTA, have improved the accuracy of lesion detection. Pharmacological treatment, especially with beta-blockers and calcium channel blockers, remains essential. The endovascular approach has emerged as a viable alternative to open surgery, with lower morbidity and mortality and faster recovery. Management challenges include the lack of consensus on guidelines and the identification of risk subgroups. Conclusion: The review highlights the importance of a multidisciplinary approach in the diagnosis and treatment of aortic dissection. It highlights the continued need for research to improve clinical outcomes and promote education about the signs and symptoms of the disease. Technological advances, such as gene therapy, offer promising prospects for future management of the condition.

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Author Biographies

Lucas Mainardo Rodrigues Bezerra

Instituto de Educação Superior do Vale do Parnaíba-IESVAP.

Carlos Daniel Spindola Melo

Acadêmico de Medicina.

Luis Gustavo Caldas de Araújo

Acadêmico de Medicina.

Eduardo Vidal da Mota Santos

Acadêmico de Medicina.

Maria Eduarda Lima Teixeira Mota

Acadêmica de Medicina.

Jader Moura Fernandes Pereira

Acadêmico de Medicina.

Luma Neves Osterno Aguiar

Academica de medicina.

Thiago Carvalho Lima

Acadêmico de Medicina

References

AKIN, Ibrahim; NIENABER, Christoph A. Prediction of aortic dissection. Heart, 2020. DOI: https://doi.org/10.1136/heartjnl-2020-316617

ALBUQUERQUE, Luciano Cabral et al. Diretrizes para o tratamento cirúrgico das doenças da aorta da Sociedade Brasileira de Cirurgia Cardiovascular: atualização 2009. Brazilian Journal of Cardiovascular Surgery, v. 24, p. 7-33, 2009. DOI: https://doi.org/10.1590/S0102-76382009000300004

ALFSON, Daniel B.; HAM, Sung W. Type B aortic dissections: current guidelines for treatment. Cardiology clinics, v. 35, n. 3, p. 387-410, 2017. DOI: https://doi.org/10.1016/j.ccl.2017.03.007

AYALA, Iván Alejandro De León; CHEN, Ying-Fu. Acute aortic dissection: an update. The Kaohsiung Journal of Medical Sciences, v. 28, n. 6, p. 299-305, 2012. DOI: https://doi.org/10.1016/j.kjms.2011.11.010

COYLE, Siobhan et al. Diagnostic testing in acute aortic dissection. Current Emergency and Hospital Medicine Reports, v. 2, p. 97-103, 2014. DOI: https://doi.org/10.1007/s40138-014-0044-8

DINATO, Fabrício José; DIAS, Ricardo Ribeiro; HAJJAR, Ludhmila Abrahão. Dissecção da aorta: manejo clínico e cirúrgico. Rev. Soc. Cardiol. Estado de Säo Paulo, p. 260-266, 2018. DOI: https://doi.org/10.29381/0103-8559/20182803260-6

EVANGELISTA, Arturo et al. Insights from the international registry of acute aortic dissection: a 20-year experience of collaborative clinical research. Circulation, v. 137, n. 17, p. 1846-1860, 2018. DOI: https://doi.org/10.1161/CIRCULATIONAHA.117.031264

LOVATT, Saul et al. Misdiagnosis of aortic dissection: A systematic review of the literature. The American journal of emergency medicine, v. 53, p. 16-22, 2022. DOI: https://doi.org/10.1016/j.ajem.2021.11.047

MALAISRIE, S. Christopher et al. The American Association for Thoracic Surgery expert consensus document: surgical treatment of acute type A aortic dissection. The Journal of thoracic and cardiovascular surgery, v. 162, n. 3, p. 735-758. e2, 2021. DOI: https://doi.org/10.1016/j.jtcvs.2021.04.053

MILEWICZ, Dianna M. Stopping a killer: improving the diagnosis, treatment, and prevention of acute ascending aortic dissections. Circulation, v. 124, n. 18, p. 1902-1904, 2011. DOI: https://doi.org/10.1161/CIRCULATIONAHA.111.059337

MORELLO, Fulvio et al. Biomarkers for diagnosis and prognostic stratification of aortic dissection: challenges and perspectives. Biomarkers in medicine, v. 8, n. 7, p. 931-941, 2014. DOI: https://doi.org/10.2217/bmm.14.38

NIENABER, Christoph A. et al. Aortic dissection. Nature reviews Disease primers, v. 2, n. 1, p. 1-18, 2016. DOI: https://doi.org/10.1038/nrdp.2016.53

NIENABER, Christoph A.; CLOUGH, Rachel E. Management of acute aortic dissection. The Lancet, v. 385, n. 9970, p. 800-811, 2015. DOI: https://doi.org/10.1016/S0140-6736(14)61005-9

NORDON, Ian M. et al. Management of acute aortic syndrome and chronic aortic dissection. Cardiovascular and interventional radiology, v. 34, p. 890-902, 2011. DOI: https://doi.org/10.1007/s00270-010-0028-3

SALMASI, M. Yousuf et al. Diagnosis and management of acute Type-A aortic dissection in emergency departments: Results of a UK national survey. International Journal of Cardiology, v. 300, p. 50-59, 2020. DOI: https://doi.org/10.1016/j.ijcard.2019.09.074

SAYED, Ahmed; MUNIR, Malak; BAHBAH, Eshak I. Aortic dissection: a review of the pathophysiology, management and prospective advances. Current Cardiology Reviews, v. 17, n. 4, 2021. DOI: https://doi.org/10.2174/1573403X16666201014142930

SILASCHI, Miriam; BYRNE, Jonathan; WENDLER, Olaf. Aortic dissection: medical, interventional and surgical management. Heart, 2016. DOI: https://doi.org/10.1136/heartjnl-2015-308284

Published

05/03/2024

How to Cite

Mainardo Rodrigues Bezerra, L., Spindola Melo, C. D., Caldas de Araújo, L. G., Vidal da Mota Santos, E., Lima Teixeira Mota, M. E., Moura Fernandes Pereira, J., … Carvalho Lima , T. (2024). AORTIC DISSECTION: DIAGNOSTIC AND THERAPEUTIC STRATEGIES - A LITERATURE REVIEW. RECIMA21 - Revista Científica Multidisciplinar - ISSN 2675-6218, 5(3), e534963. https://doi.org/10.47820/recima21.v5i3.4963