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Rios JL, Magee GA. Genetics of Thoracic and Thoracoabdominal Aortic Dissections and Aneurysms. Cardiol Clin 2025; 43:323-328. [PMID: 40268360 DOI: 10.1016/j.ccl.2024.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/25/2025]
Abstract
Acute aortic dissection is a life-threatening event that requires immediate medical attention and surgical intervention. Aortic dissections affect 4 to 5 per 10,000 individuals in the USA. These emergency events can have as high as a 50% mortality risk. Twenty percent of patients who develop a thoracic aortic dissection have an underlying genetic cause for their increased risk for aortic aneurysm and dissection, which can be identified using genetic testing. Genes associated with abdominal aortic aneurysm and dissection have been identified but have not been reported for clinical use or management at this time.
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Affiliation(s)
- Jennifer L Rios
- Department of Surgery, Keck Medical Center of USC, 1520 San Pablo Street, #4300, Los Angeles, CA 90033, USA.
| | - Gregory A Magee
- Department of Surgery, Keck Medical Center of USC, 1520 San Pablo Street, #4300, Los Angeles, CA 90033, USA
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2
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Burger JJ, van Bemmel C, Keukens D, Pomstra R, van der Wees PJ, Koenders N. Losing, regaining, and continuing to build self-confidence - a qualitative, phenomenological study of being physically active with a type B aortic dissection. Disabil Rehabil 2025; 47:1485-1492. [PMID: 38967799 DOI: 10.1080/09638288.2024.2375060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 06/07/2024] [Accepted: 06/27/2024] [Indexed: 07/06/2024]
Abstract
PURPOSE To gain a comprehensive understanding of experiences related to being physically active in participants with an uncomplicated type B aortic dissection. MATERIALS AND METHODS We performed a qualitative, phenomenological study. First-person accounts of adults, who at least one year ago had an uncomplicated type B aortic dissection, were collected using semi-structured interviews. The audio recordings of the interviews were transcribed verbatim and analyzed with interpretative phenomenological analysis. RESULTS We collected, in total, 644 min interview data from 14 participants. Three patterns were interpreted: losing self-confidence, regaining self-confidence, and continuing to build self-confidence. Experiencing symptoms when pushing limits, challenges with energy management, and side effects of medication caused loss of self-confidence. Changes in identity, reaching milestones that reflect improvement, and support from others and tools helped participants regain self-confidence. To continuing to build self-confidence, participants indicated they needed success experiences and activities make life worth living. CONCLUSIONS Self-confidence in adults with an uncomplicated type B aortic dissection changes immediately after the diagnosis of the aortic dissection. Rehabilitation professionals can support adults regaining and continuing to build self-confidence, aiming for the perfect balance between blood pressure regulation, quality of life, and being physically active. Implications for rehabilitationRehabilitation professionals should support regaining and continuing to build self-confidence related to being physically active in adults with type B aortic dissection in the early stages of recovery and beyond.Adults with an uncomplicated type B aortic dissection want rehabilitation professionals to tell them primarily what is possible (recommendations) rather than what is not allowed (rules).Rehabilitation professionals should help adults with an uncomplicated type B aortic dissection to explore, push and, ultimately, accept limits related to exercise tolerance.
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Affiliation(s)
- Joren J Burger
- Department of Rehabilitation, Radboud University Medical Center, Nijmegen, The Netherlands
- Clinical Health Sciences, Utrecht University Medical Center, Utrecht, The Netherlands
| | | | - Deborah Keukens
- Stichting Aortadissectie Nederland, The Hague, The Netherlands
| | - Roelie Pomstra
- Stichting Aortadissectie Nederland, The Hague, The Netherlands
| | - Philip J van der Wees
- Department of Rehabilitation, Radboud University Medical Center, Nijmegen, The Netherlands
- IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Niek Koenders
- Department of Rehabilitation, Radboud University Medical Center, Nijmegen, The Netherlands
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Bacour N, Grewal S, Theijsse RT, Klautz RJM, Grewal N. From Survival to Recovery: Understanding the Life Impact of an Acute Aortic Dissection Through Activity, Sleep, and Quality of Life. J Clin Med 2025; 14:859. [PMID: 39941528 PMCID: PMC11818542 DOI: 10.3390/jcm14030859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2024] [Revised: 01/21/2025] [Accepted: 01/26/2025] [Indexed: 02/16/2025] Open
Abstract
Background/Objectives: An acute aortic dissection (AAD) is a cardiovascular emergency with high mortality rates if left untreated. Survival has increased due to improvements in diagnosis and therapy. However, during their recovery, survivors frequently encounter major social, psychological, and physical challenges. This study aimed to evaluate the recovery experience of AAD survivors in The Netherlands. Insights on sleep quality, physical activity, and quality of life were collected from a unique nationwide cohort of AAD survivors recruited through the national patient support network 'Stichting Aorta Dissectie Nederland'. Methods: This study was conducted among AAD survivors who were recruited through a national association for aortic dissection known as 'Stichting Aorta Dissectie Nederland (SADN)'. The participants (n = 61) completed questionnaires assessing demographic data, physical activity, sleep quality, and health-related QoL. Results: The cohort had a mean age of 60.1 years, and 47.5% of the participants were female. The prevalence of sleep disruptions was high, as 55.7% of the people were categorized as bad sleepers (PSQI > 5). Poor sleep was associated with low physical activity and a higher BMI. The physical activity levels varied, with 47.5% reporting moderate activity levels and 44.3% reporting high activity levels. The QoL scores varied greatly among the participants, with significant impairment across all fields and reduced enthusiasm for daily activities. Poor sleepers reported significantly lower QoL (p < 0.001). Conclusions: Our study highlights significant gaps in post-AAD care, particularly addressing QoL, sleep, and physical activity. By acknowledging the multifaceted nature of recovery, healthcare providers can develop tailored interventions that empower survivors to achieve better quality of life.
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Affiliation(s)
- Nora Bacour
- Department of Cardiothoracic Surgery, Amsterdam University Medical Center Location AMC, 1105 AZ Amsterdam, The Netherlands; (N.B.); (R.T.T.); (R.J.M.K.)
| | - Simran Grewal
- Department of Orthopaedic Surgery, Onze Lieve Vrouwe Gasthuis, 1091 AC Amsterdam, The Netherlands;
| | - Rutger T. Theijsse
- Department of Cardiothoracic Surgery, Amsterdam University Medical Center Location AMC, 1105 AZ Amsterdam, The Netherlands; (N.B.); (R.T.T.); (R.J.M.K.)
| | - Robert J. M. Klautz
- Department of Cardiothoracic Surgery, Amsterdam University Medical Center Location AMC, 1105 AZ Amsterdam, The Netherlands; (N.B.); (R.T.T.); (R.J.M.K.)
- Department of Cardiothoracic Surgery, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Nimrat Grewal
- Department of Cardiothoracic Surgery, Amsterdam University Medical Center Location AMC, 1105 AZ Amsterdam, The Netherlands; (N.B.); (R.T.T.); (R.J.M.K.)
- Department of Cardiothoracic Surgery, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- Department of Anatomy and Embryology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
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Shinske AD, Hostetler E, Fowler C, Owens G, Campos C, Hilton V, MacCarrick G. Support and resources for patients with aortic disease. Vasc Med 2024; 29:362-366. [PMID: 38544455 DOI: 10.1177/1358863x241237185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Affiliation(s)
| | - Ellen Hostetler
- The John Ritter Foundation for Aortic Health, Los Angeles, CA, USA
| | | | - Gareth Owens
- Aortic Dissection Awareness UK & Ireland, Surrey, UK
| | - Chrisanne Campos
- Genetic Aortic Disorders Association Canada, Mississauga, ON, Canada
| | | | - Gretchen MacCarrick
- McKusick-Nathans Department of Genetic Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
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Sorrell A, Martin CD, Ruiz M, Bates MJ, Degner B, MacCarrick G, Sears SF. Vascular Disease Patient Information Page: Coping with a serious vascular disease diagnosis. Vasc Med 2024; 29:99-102. [PMID: 38334092 DOI: 10.1177/1358863x231225465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Affiliation(s)
- Anne Sorrell
- Department of Psychology, East Carolina University, Greenville, NC, USA
| | - Caroline D Martin
- Department of Psychology, East Carolina University, Greenville, NC, USA
| | - Michelle Ruiz
- Department of Psychology, East Carolina University, Greenville, NC, USA
| | - Michael J Bates
- Department of Cardiovascular Sciences, East Carolina Heart Institute at East Carolina University, Greenville, NC, USA
| | - Benjamin Degner
- Department of Cardiovascular Sciences, East Carolina Heart Institute at East Carolina University, Greenville, NC, USA
| | - Gretchen MacCarrick
- McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Samuel F Sears
- Department of Psychology, East Carolina University, Greenville, NC, USA
- Department of Cardiovascular Sciences, East Carolina Heart Institute at East Carolina University, Greenville, NC, USA
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McClure RS, Lindsay TF, Keir M, Bayne JP, Berry RF, Chu MWA, Chung JCY, Dagenais F, Ducas RA, Duncan A, Horne G, Klass D, Mongeon FP, Richer J, Rommens KL. The Aortic Team Model and Collaborative Decision Pathways for the Management of Complex Aortic Disease: Clinical Practice Update From the Canadian Cardiovascular Society/Canadian Society of Cardiac Surgeons/Canadian Society for Vascular Surgery/Canadian Association for Interventional Radiology. Can J Cardiol 2023; 39:1484-1498. [PMID: 37949520 DOI: 10.1016/j.cjca.2023.07.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/30/2023] [Accepted: 07/31/2023] [Indexed: 11/12/2023] Open
Abstract
Disease of the aortic arch, descending thoracic, or thoracoabdominal aorta necessitates dedicated expertise across medical, endovascular, and surgical specialties. Cardiologists, cardiac surgeons, vascular surgeons, interventional radiologists, and others have expertise and skills that aid in the management of patients with complex aortic disease. No specialty is uniformly expert in all aspects of required care. Because of this dispersion of expertise across specialties, an aortic team model approach to decision-making and treatment is advocated. A nonhierarchical partnership across specialties within an interdisciplinary aortic clinic ensures that all treatment options are considered and promotes shared decision-making between the patient and all aortic experts. Furthermore, regionalization of care for aortic disease of increased complexity assures that the breadth of treatment options is available and that favourable volume-outcome ratios for high-risk procedures are maintained. An awareness of best practice care pathways for patient referrals for preventative management, acute care scenarios, chronic care scenarios, and pregnancy might facilitate a more organized management schema for aortic disease across Canada and improve lifelong surveillance initiatives.
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Affiliation(s)
- R Scott McClure
- Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada.
| | - Thomas F Lindsay
- Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Michelle Keir
- Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada
| | - Jason P Bayne
- Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Robert F Berry
- QEII Health Sciences Centre, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Michael W A Chu
- London Health Sciences Centre, Western University, London, Ontario, Canada
| | - Jennifer C-Y Chung
- Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Francois Dagenais
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Quebec City, Quebec, Canada
| | - Robin A Ducas
- St Boniface Hospital, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Audra Duncan
- London Health Sciences Centre, Western University, London, Ontario, Canada
| | - Gabrielle Horne
- QEII Health Sciences Centre, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Darren Klass
- Vancouver Coastal Health, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Julie Richer
- University of Ottawa, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Kenton L Rommens
- Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada
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Lang X, Feng D, Huang S, Liu Y, Zhang K, Shen X, Huang J, Wang Q. How to help aortic dissection survivors with recovery?: A health promotion program based on the comprehensive theory of health behavior change and literature review. Medicine (Baltimore) 2023; 102:e33017. [PMID: 36800621 PMCID: PMC9935995 DOI: 10.1097/md.0000000000033017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 01/30/2023] [Indexed: 02/19/2023] Open
Abstract
For aortic dissection survivors, health promotion can help them recover from the disease, which requires systematic program support. The aim of this study was to construct a health promotion program for aortic dissection survivors. Literature search, group discussion, and expert consultation were used. The Integrated Theory of Health Behavior Change was the theoretical basis of the program. Multiple medical-related databases were searched. Based on a literature search and group discussion, 3 primary items, 8 secondary items, and 34 tertiary items were formed. After 2 rounds of expert consultation (number of experts = 25), 3 primary items, 16 secondary items, and 54 tertiary items were retained. The authority coefficients of the 2 rounds of experts were 0.890 and 0.905, respectively. The Kendall W coefficient of the 2 rounds were 0.210 to 0.370 (P < .05) and 0.221 to 0.378 (P < .05), respectively. The mean importance value and coefficient of variation of each item were >3.5 and <0.25, respectively. The health promotion program constructed in this study was reasonable and scientific, which could provide a reference for clinical work.
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Affiliation(s)
- Xiaorong Lang
- School of Nursing, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei Province, China
- Emergency Department, Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Danni Feng
- School of Nursing, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei Province, China
- Emergency Department, Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Sufang Huang
- Emergency Department, Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Yucheng Liu
- School of Nursing, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Kexin Zhang
- School of Nursing, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Xiaoxuan Shen
- School of Nursing, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Jingjing Huang
- School of Nursing, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Quan Wang
- School of Nursing, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei Province, China
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Lee JR, Lawrence SO, Soto M, Case M, Cotter N, Howitt J, Soderlund T, Trotter D, Byers PH, Shalhub S. The Aortic Dissection Collaborative: Methods for Building Capacity for Patient-Centered Outcomes Research in the Aortic Dissection Community. Semin Vasc Surg 2022; 35:9-15. [DOI: 10.1053/j.semvascsurg.2022.02.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/31/2022] [Accepted: 02/10/2022] [Indexed: 11/11/2022]
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