In this issue of the Journal, Mahmood et al report seven patients, without any known previous aortic or connective tissue disorder, that presented with spontaneous rupture of the ascending aorta. The mean ascending aortic diameter in these patients at the time of rupture was 4.60 ± 0.62 cm, well below the established guidelines for surgical intervention. The most common presentation was chest pain in a patient with a known history of hypertension. Interestingly, 5.7% of the patients presented with stable hemodynamics and one patient had no definitive signs of aortic pathology on computed tomography imaging. Only two patients in this series, with a mean diameter of 4.25 ± cm, were being followed for aortic dilatation. This suggests that other parameters to monitor the risk of aortic rupture, such as the Aortic Height Index, which takes into account the patient's height and not the more complicated body surface area measurement, may be a more reliable measurement of risk prediction for aortic rupture than simply aortic diameter.This study also demonstrates the importance of timely imaging and a high index of suspicion, which is essential to make a prompt diagnosis of this life‐threatening disease. The creation of a multidisciplinary aortic emergency team to triage these patients for the proper imaging studies and expedite their transfer to the operating room has contributed significantly to the outstanding results achieved by this group and should become the standard of care in all institutions dealing with acute aortic pathology.REFERENCESMahmood SUB, Ulrich A, Safdar B, et al. Spontaneous rupture of the ascending aorta. J Card Surg. 2018;33:107–114.Booher AM, Eagle KA. Diagnosis and management issues in thoracic aortic aneurysm. Am Heart J. 2011;162:38–46.Zofar MA, Li Y, Rizzo JA, et al. Height alone (rather than body surface area) suffices for risk estimation in ascending aortic aneurysm. J Thorac Cardiovasc Surg. 2018. (in press; https://doi.org/10:1016/J.JTCVS, 2017.10.140).
Journal of Cardiac Surgery – Wiley
Published: Jan 1, 2018
It’s your single place to instantly
discover and read the research
that matters to you.
Enjoy affordable access to
over 18 million articles from more than
15,000 peer-reviewed journals.
All for just $49/month
Query the DeepDyve database, plus search all of PubMed and Google Scholar seamlessly
Save any article or search result from DeepDyve, PubMed, and Google Scholar... all in one place.
Get unlimited, online access to over 18 million full-text articles from more than 15,000 scientific journals.
Read from thousands of the leading scholarly journals from SpringerNature, Elsevier, Wiley-Blackwell, Oxford University Press and more.
All the latest content is available, no embargo periods.
“Hi guys, I cannot tell you how much I love this resource. Incredible. I really believe you've hit the nail on the head with this site in regards to solving the research-purchase issue.”Daniel C.
“Whoa! It’s like Spotify but for academic articles.”@Phil_Robichaud
“I must say, @deepdyve is a fabulous solution to the independent researcher's problem of #access to #information.”@deepthiw
“My last article couldn't be possible without the platform @deepdyve that makes journal papers cheaper.”@JoseServera