Most patients with aortic diseases present with symptoms. The majority of the symptoms are vague and the patients cannot remember them exactly, even when they occur intermittently. All symptoms could be secondary to another illness. The most important symptom of aortic aneurysm detection is the pain, a sudden, unexpected back discomfort. Symptoms are often associated with an abdominal bruit, pulsatile thoracoabdominal compression, or cardiac murmur.
Aortic diseases cannot be cured. However, a correct diagnosis, early surgery, aggressive medical and surgical treatment and patient education lead to a low incidence of reinterventions.
The aortic diseases common clinical presentation and pathophysiology is similar in both sexes. However, the clinical presentations and treatments among the aortic diseases in women are different from those in men. Patients with Marfan syndrome are treated with prophylactic surgery, and patients with Ehlers Danlos Syndrome are treated with anti-loosening therapy and rehabilitation exercises. Patients with Infantile Marfan Syndrome are treated predominantly with medical management (prophylaxis medications, bracing, and surgery options) and surgical treatment to relieve certain symptoms. Patients with aortic aneurysm are treated and managed in an interdisciplinary approach and are not treated with surgery.
Aortic stenosis, aortic dilatation and dissections are often observed together. Patients with all of the signs and symptoms of aortic stenosis may have dilatation, dissections, degenerative and calcified lesions. The patients with dilatation and dissection need surgery. The occurrence of all three features together suggests that the aortic stenosis is the cause of the dissecting aneurysm and the dilated aorta. Surgical repair of aortic stenosis can prevent dissection or aneurysm formation.
The presence of atherosclerosis was shown in about one third of the patients, irrespective of the surgical procedures. The prevalence of aortic stenosis or aortic coarctation was low in both group of cases. However, it has to be stressed that the presence of atherosclerosis or stenosis are not the primary pathogenesis of aortic diseases.
About 26.6% of aortic disease are present in the US population. Aortic disease are more predominant in female patients (37.5%). This sex related incidence of aortic disease seems to be related to smoking and hypertriglyceridemia. Aortic disease seems to present earlier in patients older than 65 years than in younger patients. If surgically treated, aortic disease patients can expect a good life expectancy.
Aortic aneurysm is a common disease that affects more than 740,000 people each year in the US. Aortic surgery leads to a low risk of death or major complications that can be reduced by minimizing nonessential surgeries and complications of surgery. The newest advances in cardiopulmonary bypass that may improve long-term survival following surgery for aortic diseases include the use of aprotinin during operations and extracorporeal oxygenation.
When assessing the effects of HCA in the treatment of EVAR, surgeons typically focus on the technical outcome of the procedure. Although technically accurate and safe, many patients experience more prolonged cardiogenic shock after EVAR with HCA. Although long-term outcomes of patients are mostly excellent, surgeons should focus on avoiding prolonged cardiogenic shock when performing EVAR using HCA.
The present study suggests that, with regard to the incidence and outcome of neurological deficits and death in an unselected population, the mean total cardiopulmonary bypass time in the first 30 days of operation was not associated with increased morbidity or mortality after aortic operations.
The quality of life of both the patients with and the relatives of patients is generally low. The subjective quality of life of the patients worsens during the operation. Therefore, it is important for the aortic root replacement to consider a good postoperative quality of life. In a recent study, findings of the present study support the use of HCA.
There has been a steady increase in both the survival and the prevention of new deaths due to cardiac disease in the United States since 1970. The most common cardiovascular diagnoses in the United States are coronary heart disease (CHD) (53 million) and peripheral vascular disease (9 million). There are two new advances that have contributed substantially to the treatment of aortic disease in the present report. The first is that advances related to prevention, surgery, and drug administration for CHD have resulted in an increase in the number of patients capable of surviving the disease after its onset.
There is a strong correlation between the severity and extent of dissections in aortic aneurysms. The major predisposing factor for this condition is a combination of high systolic blood pressure and a long duration of hypertension (at least 45 years).