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Clinical and imaging surveillance of survivors of acute type A aortic dissection
Session:
SESSÃO DE POSTERS 50 - DIAGNÓSTICO E PROGNÓSTICO NA CIRURGIA CARDÍACA
Speaker:
Nuno Carvalho Guerra
Congress:
CPC 2025
Topic:
G. Aortic Disease, Peripheral Vascular Disease, Stroke
Theme:
22. Aortic Disease
Subtheme:
22.6 Aortic Disease – Clinical
Session Type:
Cartazes
FP Number:
---
Authors:
Nuno Guerra; Francisca Montenegro; Tiago Velho; Beatriz Vargas Andrade; Mariana Saraiva; Gonçalo Cabral; Oliveira Baltazar; Angelo Nobre; Luís Mendes Pedro
Abstract
<p>Clinical and imaging surveillance of survivors of acute type A aortic dissection</p> <p> </p> <p>Introduciton: Clinical and imaging surveillance in survivors of acute type A aortic dissection (ATAAD) is not fully established and varies from region to region, despite recent attempts at standardizing care after ATAAD, with the aim of better detecting and manage proximal and distal complications of dissection.</p> <p>Objective: to measure the completeness of adequate clinical and imaging follow up in survivors of ATAAD.</p> <p>Methods: We retrospectively collected 402 consecutive ATAAD operated in our center since January 2001 to November 2024. Clinical and imagiological databases were searched to determine last appointment with Cardiology and Cardiac or Vascular Surgery, last cardiac (echocardiogram) and aortic imaging (Angio CT scan or Angio MRI) and the National Health Registry (RNU) was consulted individually to ascertain vital status. Data was analyzed with Excel 15.</p> <p>Results: We identified 402 ATAAD, of which only 397 had an entry in the RNU and were analyzed (foreigners not living in Portugal were excluded). 63,0% were males and median age was 62,2 +/- 13,6 years (lower 15 years, highest 85 years). In-hospital mortality was 97 pts (24,4%). 23 patients were discharged but died before 1 year and were not considered for Surveillance purposes. 277 patients survived over 1 year and in these patients average follow-up was 3080 +/- 2043 days. We were able to obtain complete follow-up regarding clinical surveillance and imaging status in 227 patients. 61,6% of patients had underwent at least an echocardiogram after the surgery. Of these, 78 had an echocardiogram over 1 year old. Average and median time since last echocardiogram were 979 and 515 days. Overall, of patients with complete follow-up, 72,7% had never done an echo or it was over 1 year old. Similar findings were seen in distal aortic imaging. 128 patients (56,4%) had at least an aortic study after the surgery. Average and median time since last aortic study was 970 and 570 days respectively. Overall, of patients with complete follow-up, 170 (74,8%) had never underwent an aortic study or it was over 1 year old. 102 (44,9%) of patients with complete follow-up were regularly followed by a Cardiologist, and 24,6% of patients with complete follow-up were were regularly followed by a Vascular surgeon.</p> <p>Conclusion: clinical and imagiological follow-up of survivors of ATAAD is frequently insufficient, and dedicated protocols for clinical and imaging surveillance may be needed.</p> <p> </p>
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