News | Structural Heart | August 25, 2016

Aortic Dissection Plagues Family Members Around Same Age

New study suggests patients with family history of structural heart problems should seek screening beginning at the age when those family members suffered their ailments

aortic dissection, family history, same age, clinical study, John A. Elefteriades, Annals of Thoracic Surgery

August 25, 2016 — People with a family member who had an aortic dissection — a spontaneous tear in one of the body’s main arteries — should take note of the age that family member was when the aortic dissection occurred. According to a new study published online in The Annals of Thoracic Surgery, aortic dissections have the potential to run in families and often occur within 10 years of the same age.

“This study allows us to better appreciate the playbook of aortic dissection,” said John A. Elefteriades, M.D., of the Aortic Institute at Yale-New Haven Hospital in Connecticut. “Knowing how dissection operates — in this case, at what age dissections are likely to occur in a specific family — permits us to combat it more effectively and save many lives.”

Elefteriades, along with lead author Alan S. Chou, BA, and other colleagues, determined that aortic dissections tend to cluster by age in family members. The group reviewed information for 298 aortic dissection patients treated from 1990 to 2014 at the Aortic Institute at Yale. Detailed family histories were available for 90 patients. Among these patients, more than 50 percent of familial dissections occurred within a 10-year age span, and the odds increased within certain age groups.

For patients who experienced an aortic dissection between the ages of 30 to 49 years, 71 percent of familial dissections occurred in that timeframe. For those aged 60 to 79 years at the time of onset, 80 percent of other family member dissections occurred beyond the age of 50 years.

“Family history is very important and is one factor in our ‘guilt by association paradigm’ for identifying patients at risk,” explained Elefteriades. “If a family member suffered an aortic aneurysm or aortic dissection, chances are at least 1 in 8 that you may experience something similar in the future.”

When an aortic dissection occurs, blood moves through a tear in the wall of the aorta and causes the inner and middle layers of the aorta to separate (dissect). In most cases, the aorta was made vulnerable by an aortic aneurysm, which is a balloon-like bulge in the aorta. Risk factors for tearing include poorly controlled high blood pressure, injury to the chest, extreme exertion and illicit drug abuse, as well as connective tissue disorders such as Marfan Syndrome. Symptoms are similar to a heart attack, and once a tear develops, severe, knife-like chest pain usually results.

Aortic dissection is relatively rare and can be fatal. The Centers for Disease Control and Prevention reports that each year, a ruptured or dissecting thoracic aortic aneurysm is the primary or contributing cause in more than 15,000 deaths in the United States. When an aortic dissection occurs in the first part of the aorta (ascending aorta), up to 90 percent of patients can be saved with emergency surgery. But as many as 40 percent of people with aortic dissections die instantly, and the risk of the death increases 1 percent every hour the diagnosis and surgical repair are delayed, according to the “Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease” from multiple societies, including the American Heart Association and The Society of Thoracic Surgeons. Olympic volleyball star Flo Hyman and actors Lucille Ball and John Ritter all died from thoracic aortic dissections.

Early detection and enhanced clinical management are possible when family patterns are considered during the clinical decision-making process, according to this study. Elefteriades stated that family members of dissectors are important candidates for prophylactic (preventative) screening (computed tomography, magnetic resonance imaging and transthoracic echocardiogram), with frequent and careful surveillance beginning 10 to 15 years before the age of the family member who had a dissection.

“If patients are approaching the age at which one of their family members suffered an aortic dissection, they need to be very vigilant,” said Elefteriades. “If patients have aneurysms in their family, get checked. If they have premature sudden death in their family, get checked. If they themselves have an aneurysm, comply with regular follow-up visits.”

In addition, the study suggests that in patients known to have moderate-sized aneurysms and a family history of aortic dissection, prophylactic surgery should be strongly considered as those patients reach the age of their family member’s dissection.

“We can keep patients safe once we know they are at risk,” said Elefteriades. “Be reassured that with many thoracic aortic aneurysms, a full, normal life expectancy can be restored after protective aortic surgery.”

For more information: www.annalsthoracicsurgery.org

Related Content

DISRUPT BTK Study Shows Positive Results With Lithoplasty in Calcified Lesions Below the Knee
News | Peripheral Artery Disease (PAD)| September 20, 2017
Shockwave Medical reported positive results from the DISRUPT BTK Study, which were presented at the annual...
Corindus Announces First Patient Enrolled in PRECISION GRX Registry
News | Robotic Systems| September 18, 2017
September 18, 2017 — Corindus Vascular Robotics Inc.
Two-Year ILLUMENATE Trial Data Demonstrate Efficacy of Stellarex Drug-Coated Balloon
News | Drug-Eluting Balloons| September 18, 2017
Philips announced the two-year results from the ILLUMENATE European randomized clinical trial (EU RCT) demonstrating...
Sentinel Cerebral Protection System Significantly Reduces Stroke and Mortality in TAVR
News | Embolic Protection Devices| September 18, 2017
September 18, 2017 – Claret Medical announced publication of a new study in the...
NIAID Scientists Illuminate Mechanism of Increased Cardiovascular Risks With HIV
News | Cardiac Diagnostics| September 14, 2017
September 14, 2017 — Scientists at the National Institutes of Health have expanded the understanding of how chronic i
Marijuana Associated With Three-Fold Risk of Death From Hypertension
News | Hypertension| September 14, 2017
Marijuana use is associated with a three-fold risk of death from hypertension, according to research published recently...
Peter Schneider, M.D. presents late breaking clinical trial results at VIVA 17 in Las Vegas. Panelists (l to r) Krishna Rocha-Singh, M.D., Sean Lyden, M.D., John Kaufman, M.D., Donna Buckley, M.D.

Peter Schneider, M.D. presents late breaking clinical trial results at VIVA 17 in Las Vegas. Panelists (l to r) Krishna Rocha-Singh, M.D., Sean Lyden, M.D., John Kaufman, M.D., Donna Buckley, M.D.

Feature | Cath Lab| September 14, 2017
September 14, 2017 — Here are quick summaries for all the key late-breaking vascular and endovascular clinical trials
Sponsored Content | Videos | Structural Heart Occluders| September 13, 2017
Ziyad Hijazi, M.D., MPH, MSCAI, FACC, director of the cardiac program and chair of the Department of Pediatrics at Si
Medtronic Announces Japanese Regulatory Approval for In.Pact Admiral Drug-Coated Balloon
News | Drug-Eluting Balloons| September 13, 2017
Medtronic plc announced that the In.Pact Admiral Drug-Coated Balloon (DCB) received approval from the Japanese Ministry...
PQ Bypass Reports Positive Results for Detour System in Patients With Long Femoropopliteal Blockages
News | Peripheral Artery Disease (PAD)| September 13, 2017
A subset analysis of the DETOUR I clinical trial showed promising safety and effectiveness results of PQ Bypass’ Detour...
Overlay Init