Arq. Bras. Cardiol. 2019; 112(2): 204-210
Case 1/2019 – A 51-year-old Man with Arterial Hypertension, Aortic Dissection and Aortic Valve Regurgitation, in Addition to Heart Failure with Unchanged Clinical Course After Surgical Intervention
Desiderio Favarato, Vera Demarchi Aiello
DOI: 10.5935/abc.20190013
Clinical aspects
This was a male patient, who presented with ascending aortic dissection, and who, even after surgery for dissection repair, developed a picture of severe heart failure and died.
The International Registry of Acute Aortic Dissection (IRAD) showed that patients with aortic dissection were older than our patient, 61 years; and a majority of males (63%). Regarding the diseases related to the dissection, they were: Marfan syndrome (6.7%), hypertension (69.3%), atherosclerosis (24.4%), previously known aortic aneurysm (12.4%), previous aortic dissection 3.9%) and diabetes mellitus (4.3%). Also, 15.9% had a history of previous cardiac surgery and iatrogenic cause in 4.8% (1.7% coronary angiography and 3.1% after cardiac surgery). The 2015 update of the same registry, with a ten-fold higher number of patients, showed an increase in hypertension (75.5%) and a decrease in the presence of Marfan syndrome (4.5%), (75.5%), atherosclerosis (19.6%) and previous cardiac surgery (10.6%).
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