Presentation, Diagnosis, and Outcomes of Acute Aortic Dissection: 17-Year Trends From the International Registry of Acute Aortic Dissection

none17siDiagnosis, treatment, and outcomes of acute aortic dissection (AAS) are changing.openPape, Linda A; Awais, Mazen; Woznicki, Elise M; Suzuki, Toru; Trimarchi, Santi; Evangelista, Arturo; Myrmel, Truls; Larsen, Magnus; Harris, Kevin M; Greason, Kevin; Di Eusanio, Marco; Bossone, Eduardo; Montgomery, Daniel G; Eagle, Kim A; Nienaber, Christoph A; Isselbacher, Eric M; O'Gara, PatrickPape, Linda A; Awais, Mazen; Woznicki, Elise M; Suzuki, Toru; Trimarchi, Santi; Evangelista, Arturo; Myrmel, Truls; Larsen, Magnus; Harris, Kevin M; Greason, Kevin; Di Eusanio, Marco; Bossone, Eduardo; Montgomery, Daniel G; Eagle, Kim A; Nienaber, Christoph A; Isselbacher, Eric M; O'Gara, Patric

Twenty-five years of observations from the International Registry of Acute Aortic Dissection (IRAD) and its impact on the cardiovascular scientific community

Objective: The International Registry of Acute Aortic Dissection (IRAD) celebrated its 25th anniversary in January 2021. This study evaluated IRAD's role in promoting the understanding and management of acute aortic dissection (AD) over these years. Methods: IRAD studies were identified, analyzed, and ranked according to their citations per year (c/y) to determine the most-cited IRAD studies and topics. A systematic search of the literature identified cardiovascular guidelines on the diagnosis and management of acute AD. Consequently, IRAD's presence and impact were quantified using these documents. Results: Ninety-seven IRAD studies were identified, of which 82 obtained more than 10 cumulative citations. The median c/y index was 7.33 (25th-75th percentile, 4.01-16.65). Forty-two studies had a greater than median c/y index and were considered most impactful. Of these studies, most investigated both type A and type B AD (n = 17, 40.5%) and short-term outcomes (n = 26, 61.9%). Nineteen guideline documents were identified from 26 cardiovascular societies located in Northern America, Europe, and Japan. Sixty-nine IRAD studies were cited by these guidelines, including 38 of the 42 most-impactful IRAD studies. Among them, partial thrombosis of the false lumen as a predictor of postdischarge mortality and aortic diameters as a predictor of type A occurrence were determined as most-impactful specific IRAD topics by their c/y index. Conclusions: IRAD has had and continues to have an important role in providing observations, credible knowledge, and research questions to improve the outcomes of patients with acute AD

IRAD experience on surgical type A acute dissection patients: results and predictors of mortality

Type A acute aortic dissection (TAAD) is a disease that has a catastrophic impact on a patient's life and emergent surgery represents a key goal of early treatment. Despite continuous improvements in imaging techniques, medical therapy and surgical management, early mortality in patients undergoing TAAD repair still remains high, ranging from 17% to 26%. In this setting, the International Registry of Acute Aortic Dissection (IRAD), the largest worldwide registry for acute aortic dissection, was established to assess clinical characteristics, management and outcomes of TAAD patients. The present review aimed to evaluate and comment on outcomes of TAAD surgery as reported from IRAD series