Aortic dissection: modern aspects of diagnosis and treatment

Abstract

Introduction. Aortic dissection (AD) is an acute aortic syndrome characterized by damage in the inner wall of the aorta, during which blood passes through a gap in the intimal wall of the aorta and fills a space formed by internal and medial wall of the aorta, forming a false lumen and true one. DA is a major cardiovascular emergency that has a big impact in the structure of causes of mortality and morbidity. The mortality rate of patients with untreated proximal AD increases by 1-3% per hour and reaches 25-50% on the first day from admission. Objective of the study. In-hospital death risk stratification in acute period (first 14 days) of AD using prediction model developed based IRAD study.Result: During the acute episode 19 patients (31.7%) died. According to this score patients in this study were distributed as follows: The patients that accumulated the lowest score (≥1, 5 - <3.0) = 4 (21.1% death rate, probability of death according to IRAD 33.4%) patients; The patients with average score (≥3, 0 - <4.0) = 6 (31.6% death rate, probability of death according to IRAD 33.4%) patients;The patients with the highest scores (≥4, 0 - <6.0) = 7 (47.4% death rate, probability of death according to IRAD 87.6%) patients. Conclusions: According to the IRAD model, our study revealed that the most patients died (47.4%) when they accumulated the highest score (probability of death according to IRAD 87.61%). Thus, the model for predicting in-hospital death risk provided by IRAD study can be recommended for clinical evaluation of the patients with clinically suspected aortic dissection in order to prevent negative consequences and to assess the appropriate hospital management.