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Medicina
Special Issues
Diagnosis and Management of Aortic Diseases
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Diagnosis and Management of Aortic Diseases

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (10 January 2024) | Viewed by 2481

Special Issue Editors

Dr. Paweł Rynio

E-Mail Website
Guest Editor
Department of Vascular Surgery, Medical University in Szczecin, Szczecin, Poland
Interests: thoraco-abdominal aortic aneurysm; aortic dissection; 3D printing
Prof. Dr. Andreas Hoene

E-Mail Website
Guest Editor
Department of Vascular Surgery, Medical University in Greifswald, Greifswald, Germany
Interests: vascular surgery; acute myocardial infarction; arterial embolism

Special Issue Information

Dear Colleagues, 

Aortic disorders, such as aneurysms and dissections, cause a large global health burden. Despite advances in medical understanding and imaging technology, the diagnosis and treatment of aortic illnesses continue to be challenging. In order to prevent catastrophic complications such as rupture and death, accurate diagnosis and prompt treatment are necessary. Thus, it is impossible to exaggerate the significance of establishing and implementing effective diagnostic and therapeutic strategies.

Aortic illnesses reach back to antiquity, with reports of aortic aneurysms dating back to the second century A.D. In 1951, the first successful surgical repair of an abdominal aortic aneurysm in modern times was performed. Since then, there has been a remarkable degree of progress achieved in aortic pathophysiology, imaging, and surgical techniques.

This Special Issue aims to provide a complete overview of current aortic disease research and treatment options. We encourage submissions that focus on the diagnosis, treatment, and outcomes of aortic diseases, as well as on cutting-edge research in this area.

Innovative research areas include molecular factors underlying the genesis of aortic aneurysms, innovative imaging tools for accurate diagnosis, and minimally invasive surgical techniques. We have a particular interest in publishing articles that explore disparities in the management and outcomes of aortic disease across different populations.

Scholars working in relevant areas are invited to submit studies that provide new insights into the diagnosis and management of aortic disorders in the form of original research articles, reviews, and case reports. We hope that physicians and researchers in the field of cardiovascular medicine will find this Special Issue inspiring and useful in equal measure.

Dr. Paweł Rynio
Prof. Dr. Andreas Hoene
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • aortic disorders
  • aneurysms
  • dissections
  • diagnosis
  • therapy
  • imaging
  • surgical techniques
  • molecular mechanisms

Published Papers (2 papers)

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15 pages, 1302 KiB  
Article
Factors Associated with Newly Developed Postoperative Neurological Complications in Patients with Emergency Surgery for Acute Type A Aortic Dissection
by Mircea Robu, Irina Maria Margarint, Cornel Robu, Andreea Hanganu, Bogdan Radulescu, Ovidiu Stiru, Andrei Iosifescu, Silvia Preda, Mihai Cacoveanu, Cristian Voica, Vlad Anton Iliescu and Horațiu Moldovan
Medicina 2024, 60(1), 27; https://doi.org/10.3390/medicina60010027 - 23 Dec 2023
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Abstract
Background and Objectives: Postoperative neurological complications (NCs) are an important cause of mortality in patients with acute type A aortic dissection (ATAAD). The aim of the study was to determine the association between intraoperative risk factors and newly developed postoperative NCs in [...] Read more.
Background and Objectives: Postoperative neurological complications (NCs) are an important cause of mortality in patients with acute type A aortic dissection (ATAAD). The aim of the study was to determine the association between intraoperative risk factors and newly developed postoperative NCs in patients after emergency surgery for ATAAD. Materials and Methods: A total of 203 patients requiring emergency surgery were included in the study. Patients with preoperative neurological dysfunction, deceased on the operating table or within the first 48 h after intensive care admission, with uncertain postoperative neurologic status or with incomplete records were excluded. Results: Mean age was 57.61 ± 12.27 years. Hyperlipidemia was the most frequent comorbidity (69%). A bicuspid aortic valve was present in 12.8% of cases, severe acute aortic regurgitation was present in 29.1% of patients, and cardiac tamponade was present in 27.1% of cases. The innominate artery was the most frequently dissected supra-aortic artery in 27.1% of cases. In 65% of cases, the primary entry tear was at the level of the ascending aorta. The incidence of newly developed postoperative NCs was 39.4%. The most common surgical technique performed was supra-coronary ascending aorta and hemiarch replacement, in 53.2% of patients. Using logistic regression, cardiopulmonary bypass time (OR = 1.01; 95% CI = 1.01–1.02; p < 0.001), aortic cross-clamp time over 3 h (OR = 2.71, 95% CI = 1.43–5.14, p = 0.002) and cerebral perfusion time (OR = 1.02; 95% CI = 1.002–1.03; p = 0.027) were independently associated with newly developed postoperative NCs. Conclusions: Based on the results of the study, all efforts should be made to reduce operative times. Using a simple surgical technique, like the supra-coronary ascending aorta and hemiarch technique, whenever possible, and using a simpler technique for cerebral perfusion like unilateral cerebral perfusion via the right axillary artery, could reduce operating times. Full article
(This article belongs to the Special Issue Diagnosis and Management of Aortic Diseases)
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17 pages, 5838 KiB  
Systematic Review
The Rate of Postoperative Complications in Complicated Acute, and Subacute Type B Aortic Dissections after TEVAR vs. PETTICOAT Procedures: Systematic Review and Meta-Analysis
by Natalia Niklas, Klaudia Królikowska, Kinga Zdrodowska, Piotr Gutowski, Arkadiusz Kazimierczak and Paweł Rynio
Medicina 2023, 59(12), 2150; https://doi.org/10.3390/medicina59122150 - 12 Dec 2023
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Abstract
Background and Objectives: Provisional extension to induce complete attachment (PETTICOAT) is suggested as being associated with a lower incidence of aorta-related events and fewer reinterventions compared to thoracic endovascular aortic repair (TEVAR) in patients with complicated acute, and subacute type B aortic [...] Read more.
Background and Objectives: Provisional extension to induce complete attachment (PETTICOAT) is suggested as being associated with a lower incidence of aorta-related events and fewer reinterventions compared to thoracic endovascular aortic repair (TEVAR) in patients with complicated acute, and subacute type B aortic dissections. Materials and Methods: This article is a systematic review and meta-analysis following the PRISMA guidelines. The Medline, PubMed, Embase, and Cochrane databases were searched, starting on 21 February 2022 and ending on 22 June 2022, to identify studies that investigated the rate of postoperative complications in patients treated with the PETTICOAT compared to the TEVAR. A random effects meta-analysis was performed. Of 2350 studies, 5 studies involving 360 patients were included: 143 patients after the PETTICOAT procedure and 217 after the TEVAR. Results: The meta-analysis of all studies showed that the rate of secondary endovascular reinterventions was smaller in patients treated with the PETTICOAT (n = 3 studies; OR, 0.30; 95% CI, 0.10 to 0.94; p = 0.04). The results of other postoperative complications (30-day mortality, mortality during follow-up, paraplegia, stroke, and occurrence of endoleak) were lower in the PETTICOAT group but were not statistically significant. The rate of postoperative renal failure was lower in patients treated with the TEVAR (n = 4; OR, 1.08; 95% CI, 0.46 to 2.51; p = 0.86). Conclusion: This meta-analysis suggests that the PETTICOAT procedure is related to the lower rate of secondary endovascular reinterventions for complicated acute, and subacute type B aortic dissections. Full article
(This article belongs to the Special Issue Diagnosis and Management of Aortic Diseases)
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