Abstract 13865: Impact of Prior Aortic Aneurysm Diagnosis on Presentation and Outcomes in Stanford Type B Acute Aortic Syndromes

Abstract

Introduction: Acute aortic syndromes (AAS) involving the descending, but not the ascending, aorta (Stanford type B) are medical emergencies that require multidisciplinary management. Aortic aneurysms are a known risk factor for AAS. We investigated the impact of a history of aortic aneurysm on presentation and outcomes in patients with type B AAS. Hypothesis: We hypothesize that patients with a history of aortic aneurysm have higher in-hospital mortality rate and adverse outcomes compared to those without. Methods: We performed a retrospective analysis of all patients admitted with AAS to our tertiary medical center between July 2012 and October 2020. Type B AAS presentations included aortic dissection, aortic rupture, intramural hematoma (IMH), penetrating atherosclerotic ulcer, and symptomatic aneurysm. Prior history included presence of a thoracic and/or abdominal aortic aneurysm. Results: A total of 169 patients with type B AAS were included in our analyses. Of these, 54 (32%) had a history of prior aortic aneurysm and 115 (68%) patients did not (Table). Patients with prior aortic aneurysm were significantly older (74.3±14.6 vs. 68.7±14.1 years, p <0.0001), had a lower proportion of aortic dissection (33.3% vs. 50.4%, p <0.05) and a higher proportion of symptomatic aneurysm (27.8% vs. 8.7%, p <0.001) as their presentation. Similar rates of mortality (8.9% vs. 7.4%), AAS related complications, and 30-day hospital readmission were observed between patients with a prior aortic aneurysm and those without. Conclusions: Among patients with type B AAS, those with a history of aortic aneurysm have a lower proportion of dissection and a higher proportion of symptomatic aneurysm at presentation. However, their rates of in-hospital mortality and 30-day readmission do not differ compared to those observed in patients without a history of aortic aneurysm.