Acute aortic syndromes in Yalgado Ouédraogo University Hospital: Epidemiological characteristics, diagnostic, therapeutic and evolution aspects

Abstract

ntroduction: Acute aortic syndromes (AAS) formed by
the aortic dissections, penetrating ulcer and hematoma of
the aorta represent a medical and surgical emergency by
rapidly life-threatening. The objective of this study was to
describe epidemiological, diagnostic and therapeutic
aspects and the evolution of acute aortic syndromes in
Yalgado Ouedraogo university hospital.
Patients and methods: From 1 January 2009 to 31 july
2014, we consecutively included all patients received in
the cardiology department of the University Hospital
Yalgado Ouedraogo and in whom the diagnosis of AAS
was confirmed. We conducted a clinical examination for
risk factors and paraclinical including ECG, transthoracic
and transesophageal cardiac echocardiography and thoracic computed tomography and sometimes abdominal.
Results: Seventeen cases of acute aortic syndrome
were recorded with 13 men. The average age of patients
was 55.9 ± 7.2 years [25 and 71years]. Contributing factors were mainly hypertension (100%) and smoking
(41,2%). The symptom was chest pain in 14 cases. The
transthoracic echocardiography revealed aortic regurgitation in all patients, impaired systolic function of the left
ventricle in four (4) cases, dilatation of the ascending
aorta in eight cases and the presence of an intimal flap in
seven cases. The transesophageal echocardiography performed in five patients highlighted an intimal flap in all
cases that sat at the ascending aorta. Thoracic angiography scan confirmed aortic dissection in 16 cases and one
case of intramural hematoma type A. The dissection was
type A in 15 patients. All patients received medical care
immediately. Two patients had received surgical treatment
consisting of Tyron David technique for one patient and
aortic endoprsothesis in one case. The evolution was
marked by cardiovascular collapse and death in two cases
respectively.
Conclusion: AAS are relatively common. They are dominated by the aortic dissection which type A is the most
common. Pending the effectiveness of cardiovascular
surgery in our country, the treatment comes down to medical treatment.