Mid-term follow up after an acute aortic syndrome episode: when the storm is over

• DOI: 10.1093/ehjacc/zuaf044.210
• Publication Date: 2025-04-23T11:06:53Z
• Authors: I Ramos Gonzalez-...; C F Ferrera Duran; A Carrero Fernandez; P Munoz Sahagun; J Gonzalez Del Ca...; M L Navarro Garcia; E Alvarez Rodriguez; I Martinez Lopez; J Cobiella Carnicer; M Hernandez Mateo; S M Da Rosa Beltrao; J Perez Villacast...; L Maroto Castellanos; I Vilacosta

Abstract

Introduction High morbidity and mortality associated with acute aortic syndrome (AAS) reinforces the need for close expert professional’s follow-up. However, guidelines do not specify how often or what complementary tests during this process should be performed. The aim of the present study was to analyse the prognosis of patients who survived AAS acute phase, describing comorbidities, complications, and short- and mid-term mortality.

Methods We collected prospectively and consecutively patients with AAS diagnosis treated in a tertiary hospital from 2019 to 2024. At discharge, follow-up in a specific aortic pathology monographic clinic was proposed. Follow up was divided into three period times: 6 months, 1 year and 2 years. Clinical, analytical, imaging, therapeutic and prognostic variables were collected. A descriptive analysis of comorbidities, complications and mortality was performed.

Results 132 Patients were included during the study period, of whom 78 (60%) patients continued to be followed at discharge: 53 (68%) patients with type A AAS and 25 (32%) with type B AAS. Throughout this period, most of them were evaluated in a monographic clinic (Table). Patients with type A AAS diagnosis were the most numerous and presented more mid- and long-term complications: among these, renal failure and electrocardiogram conduction disturbances were the most frequent. A quarter of the patients remained symptomatic 6 months after discharge, with earlier improvement in patients with type A AAS (Table). The proportion of patients requiring reintervention during follow-up was low (Table). In addition, mortality was equally low, reaching less than 10% in type A AAS and 0% in type B AAS at 2-year follow-up. (Table 1). Finally, causes of mortality were non-cardiovascular and non-related to the AAS in the majority of cases.

Conclusions Although the evolution of AAS is not extent of complications, once the acute phase has overcome, cardiovascular mortality in the medium- and long-term follow-up is low. In this regard, follow-up by specialized aortic pathology clinicians is essential, given the complexity of the cases and the need for multidisciplinary evaluation.