title: Acute aortic syndrome: A systems approach to a time-critical disease.
abstract: Acute aortic syndrome represents a group of potentially lethal aortic diseases, including classic acute aortic dissection, intramural hematoma, and penetrating atherosclerotic aortic ulcer. Among these conditions, type A aortic dissection is the most common acute presentation. Only surgical interventions are recommended in guidelines as lifesaving procedures for type A dissection. Despite new diagnostic imaging methods, advanced surgical strategy, and improved postoperative management in the over 250-year history of aortic dissection, in-hospital mortality and morbidity rates still remain high. Recently, several new system-based approaches, such as implementation of multidisciplinary experienced high-volume centers and establishment of regional systematic management flow have been reported to improve the outcome. Here, we will describe the pathophysiology, diagnosis, and treatment as well as the new systematic approach to treat acute aortic syndrome.
authors.affiliation: Division of Cardiac Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: kawabori.masashi@gmail.com.
authors.forename: Masashi
authors.initials: M
authors.lastname: Kawabori
authors.affiliation: Division of Cardiac Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Kaneko
mesh_terms: D001018:Aortic Diseases / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D006406:Hematoma / Q000150:complications; D006801:Humans; D012306:Risk; D013597:Systems Analysis; D013997:Time Factors
keywords: acute aortic syndrome; aortic dissection; intramural hematoma; penetrating aortic ulcer; system approach