• J. Cardiothorac. Vasc. Anesth. · Feb 2018

    Review

    Aortic Regurgitation in Acute Type-A Aortic Dissection: A Clinical Classification for the Perioperative Echocardiographer in the Era of the Functional Aortic Annulus.

    • Prakash A Patel, Joseph E Bavaria, Kamrouz Ghadimi, Jacob T Gutsche, Prashanth Vallabhajosyula, Hanjo A Ko, Nimesh D Desai, Emily Mackay, Stuart J Weiss, and Augoustides John G T JGT Cardiovascular and Thoracic Section, Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Phi.
    • Cardiovascular and Thoracic Section, Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
    • J. Cardiothorac. Vasc. Anesth. 2018 Feb 1; 32 (1): 586-597.

    AbstractThe functional aortic annulus offers a clinical approach for the perioperative echocardiographer to classify the mechanisms of aortic regurgitation in acute type-A dissection. Comprehensive examination of the functional aortic annulus in this setting using transesophageal echocardiography can guide surgical therapy for the aortic root by considering the following important aspects: severity and mechanism of aortic regurgitation, extent of root dissection, and the pattern of coronary artery involvement. The final choice of surgical therapy also should take into account factors, such as patient presentation and surgical experience, to limit mortality and morbidity from this challenging acute aortic syndrome. This review explores these concepts in detail within the framework of the functional aortic annulus, detailed anatomic considerations, and the latest literature.Copyright © 2018 Elsevier Inc. All rights reserved.

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