Tag Archives: aortic dissection

Case description An 80-year-old woman with severe symptomatic aortic stenosis was scheduled for transcatheter aortic valve implantation (TAVI), following Heart Team decision. Pre-procedural computed tomography (CT) angiogram revealed an area-derived annulus diameter of 23.7 mm, and calcium spur which extended from the coronary cusps commissure until the sinotubular junction. It was decided to implant a balloon-expandable TAVI (Sapien XT™ 26 mm) (figure 1A). Figure 1. A. Transcatheter aortic valve implantation (TAVI) positioning. B. Fluoroscopy showing contrast retention (arrow) outside the aorta and prosthetic valve skirt protusion on

A literature search in Pubmed and Google scholar disclosed 13 examples of the association of type A aortic dissection and PE (table 1).2–14 Table 1. Co-existence of aortic dissection and pulmonary embolism First author Age Sex CP BKP ARG PRP BPD MDS SOB HPTY DVT EFF ARP Antithrombotic treatment Cruz2 71 F ✓ – – ✓ – – ✓ – ✓ – – OAC Radwan3 66 F ✓ – – – – – – – – – ✓ Information not available Kagawa4 71 F – ✓ – – – ✓ – – ✓ ✓ – IVC filter, UFH, OAC, elastic stocking Herera5 47 F – – ✓ – – – ✓

Introduction The diseases of the aorta are an important cause of worldwide cardiovascular mortality and morbidity.1 Hospital admissions within the UK at the end of 2010 were identified as 8.8 for thoracic aortic dissections and 9.0 for thoracic aortic aneurysms, per 100,000 inhabitants.2 More recently, significant regional variation has been documented in access to treatment and mortality outcomes in the UK.3 These authors speculated that one of the barriers to treatment underlying this unwarranted variation was a lack of clear guidelines on population screening for this disease. Aneurysms of the thoracic aorta commonly have a genetic basis

The Aortic Dissection Charitable Trust Before 2021 no charity existed in the UK and Ireland to shine a spotlight on aortic dissection and shape a safer future for people impacted by the condition. The Aortic Dissection Charitable Trust (www.tadct.org, @aorticdissectCT) is the UK and Ireland charity uniting patients, families and the medical community in a shared goal of improving diagnosis, increasing survival and reducing disability due to aortic dissection. Our ambition is to bring consistency of treatment across the whole patient pathway through: Increased access to education for medical professionals and patients in the UK and Ireland.

Epidemiology King George II “On 25 October 1760 George II, then 76, rose at his normal hour of 6 AM, called as usual for his chocolate, and repaired to the closet-stool. The German valet de chambre heard a noise, memorably described as ‘louder than the royal wind’, and then a groan; he ran in and found the King lying on the floor, having cut his face in falling. Mr Andrews, surgeon of the household, was called and bled his Majesty but in vain, as no sign of life was observed from the time of his fall. At necropsy the next day Dr Nicholls, physician to his late Majesty, found the pericardium distended with a pint of coagulated blood,

Case A woman in her late 80s with a past medical history of severe aortic stenosis, rheumatic fever, coronary artery disease with prior myocardial infarction, and atrial flutter, presented with worsening shortness of breath, chest pain and near syncope. Prior to presentation she was undergoing evaluation for transcatheter aortic valve replacement (TAVR). Given the escalation of her symptoms, she was admitted for expedited evaluation. Upon admission, she was haemodynamically stable with a harsh systolic murmur. As a prelude to TAVR, coronary angiography was performed. The angiogram was technically challenging due to heavily calcified and tortu