International Journal of Cardiovascular and Thoracic Surgery

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Acute Aortic Dissection at the Cardiology Clinic to the University National Hospital Hubert Koutoukou Maga of Cotonou (BENIN)

Received: 1 November 2023    Accepted: 20 November 2023    Published: 6 December 2023
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Abstract

Introduction: We aimed to describe epidemiological, diagnostic, therapeutic aspects of aortic dissection (AD) managed at the CNHU-HKM of Cotonou (Benin). Methods: It was a retrospective study from january 2018 to july 2023. All patients admitted for AD were enrolled. AD was classified as type A and type B according to Stanford. DA risk factors, socio-demographic characteristics and DA characteristics were studied. Results: Of the 2883 patients admitted during the study period, there were 17 cases of AD, representing a frequency of 0.6%. The mean age was 52 ± 9 years, and the sex ratio was 3.25. Uncontrolled hypertension was the predominant risk factor (88.3%). The main manifestations of AD were chest pain (100%) and aortic insufficiency (52.94%). Chest X-rays showed enlargement of the mediastinum in all patients. Echocardiography showed intimal flap in 62.5%. The aortic angiotomodensitometry, identified 12 type A (70.59%) and 5 type B (29.41%) of AD. Surgical or endovascular treatment was performed in 6 (35.29%) patients. Lethality rate was 47.06%. Conclusion: Aortic dissection was frequent at the teaching clinic of cardiology of CNHU-HKM of Cotonou. Surgical or endovascular treatment wasn't often available, and mortality was high. Prevention of this condition must be the rule, and it requires adequate management of hypertension, which is the most common risk factor.

DOI 10.11648/j.ijcts.20230906.11
Published in International Journal of Cardiovascular and Thoracic Surgery (Volume 9, Issue 6, November 2023)
Page(s) 71-76
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Aortic Dissection, Arterial Hypertension, Cardiovascular Surgery, Benin

References
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[2] Howard DP, Sideso E, Handa A, Rothwell PM. Incidence, risk factors, outcome and projected future burden of acute aortic dissection. Ann Cardiothorac Surg 2014; 3: 278-84. doi: 10.3978/j.issn.2225-319X.2014.05.14. PMID: 24967167; PMCID: PMC4052413.
[3] Diao M, Ndiaye MB, Kane AD, Mbaye A, Doucouré I, Sarr M, et al. Diagnostic, therapeutic and evolutionary aspects of dissection in Dakar. Retrospective study of 19 cases. Médecine d'Afrique noire. 2010 Feb. 57 (8/9): 419-4. https://www.researchgate.net/publication/280446288
[4] Adjagba MP, Bognon R, Sonou A, Hounkponou M, Djoh I, Assani MS, et al. Diagnostic and prognostic particularities of aortic dissection at the cnhu-hkm of Cotonou, Benin: A propos de 6 cas en 2017. Eur Sci ESJ 2018; 14 (18): 206. Available from: https://eujournal.org/index.php/esj/article/view/10967
[5] Baliyan V, Parakh A, Prabhakar AM, Hedgire S. Acute aortic syndromes and aortic emergencies. Cardiovasc Diagn Ther. 2018 April; 8 (Suppl 1): S82-S96. doi: 10.21037/cdt.2018.03.02.
[6] Erbel R, Aboyans V, Boileau C, Bossone E, Bartolomeo RD, Eggebrecht H, et al. 2014 ESC Guidelines on the diagnosis and treatment of aortic diseases: Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC). Eur Heart J. 2014 Nov 1; 35 (41): 2873-926. doi: 10.1093/eurheartj/ehu281.
[7] Debakey ME, Henly WS, Cooley DA, Morris GC, Crawford ES, Beall AC. Surgical management of dissecting aneurysms of the aorta. J Thorac Cardiovasc Surg. 1965; 49: 130- 49. https://doi.org/10.1016/S0022-5223(19)33323-9
[8] Mancia G, Kreutz R, Brunström M, Burnier M, Grassi G, Januszewicz A, et al. 2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension Endorsed by the International Society of Hypertension (ISH) and the European Renal Association (ERA). J Hypertens. 2023 Jun 21. DOI: 10.1097/HJH.0000000000003480.
[9] Daily PO, Trueblood HW, Stinson EB, Wuerflein RD, Shumway NE. Management of acute aortic dissections. Ann Thorac Surg. 1970; 10: 237-47. https://doi.org/10.1016/S0003-4975(10)65594-4
[10] Howard D, Banerjee A, Fairhead JF, Perkins J, Silver LE, Rothwell PM et al. Population-Based Study of Incidence and Outcome of Acute Aortic Dissection and Premorbid Risk Factor Control: 10-year results from the Oxford Vascular Study. Circulation AHA Journal. 2013 May 21.127 (20): 2031-7. https://doi.org/10.1161/CIRCULATIONAHA.112.000483
[11] Dib B, Seppelt PC, Arif R, Weymann A, Veres G, Schmack B et al. Extensive aortic surgery in acute aortic dissection type A on outcome-insights from 25 years single center experience. J Cardiothorac surg. 2019 Nov 6. 14 (1): 187. https://doi.org/10.1186/s13019-019-1007-7
[12] Wang W, Duan W, Xue Y, Wang L, Liu J, Yu S et al. Clinical feactures of acute aortic dissection from the registry of aortic dissection in China. The Journal of Thoracic and Cardiovascular Surgery. 2014 December. 148 (6): 2997. https://doi.org/10.1016/j.jtcvs.2014.07.068
[13] Gebril A, Nawaz A, Ashour S, Nasr MK, Eelbelihy OE. Accidentally discovered type B silent aortic dissection in a COVID-19 positive patient. Cureus. 2023 Jul 4; 15 (7): e41373. DOI: 10.7759/cureus.41373.
[14] Golledge J, Eagle KA. Acute aortic dissection. Lancet. 2008 Jul 5; 372 (9632): 55-66. https://doi.org/10.1016/s0140-6736(08)60994-0
[15] Evangelista A, Barrabés J, Lidon RM, Rodriguez-Lecoq R. Changes in the diagnosis and management of acute aortic syndrome and associated mortality over the past 20 years. REVISTA ESPANOLA DE CARDIOLOGIA. 2021; 74: 257-262. https://doi.org/10.1016/j.rec.2020.02.015
[16] Hiratzka LF, Bakris GL, Beckman JA, Bersin RM, Carr VF, Casey DE et al. 2010 ACCF/AHA/ AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM guidelines for the diagnosis and management of patients with thoracic aortic disease: un rapport de l'American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, de l'American Association for Thoracic Surgery, de l'American College of Radiology, de l'American Stroke Association, de la Society for Cardiovascular Anesthesiologists, de la Society for Cardiovascular Angiography and Interventions, de la Society for Interventional Radiology, de la Society of Thoracic Surgeons et de la Society for Vascular Medicine. Circulation. 2010 Apr 6; 121 (13): e266-369. https://doi.org/10.1161/cir.0b013e3181d4739e.
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[18] Rousseau H, Chabbert V, Marcheix B, El Hassar O, Cron C, Lopez S. Acute aortic syndromes. STV. 2009; 21 (3): 112-25. https://pubmed.ncbi.nlm.nih.gov/24796906/
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    Bori Bata, K., Sonou, A., Dohou, H., Aïkpon, D., Agbo, M., et al. (2023). Acute Aortic Dissection at the Cardiology Clinic to the University National Hospital Hubert Koutoukou Maga of Cotonou (BENIN). International Journal of Cardiovascular and Thoracic Surgery, 9(6), 71-76. https://doi.org/10.11648/j.ijcts.20230906.11

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    ACS Style

    Bori Bata, K.; Sonou, A.; Dohou, H.; Aïkpon, D.; Agbo, M., et al. Acute Aortic Dissection at the Cardiology Clinic to the University National Hospital Hubert Koutoukou Maga of Cotonou (BENIN). Int. J. Cardiovasc. Thorac. Surg. 2023, 9(6), 71-76. doi: 10.11648/j.ijcts.20230906.11

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    AMA Style

    Bori Bata K, Sonou A, Dohou H, Aïkpon D, Agbo M, et al. Acute Aortic Dissection at the Cardiology Clinic to the University National Hospital Hubert Koutoukou Maga of Cotonou (BENIN). Int J Cardiovasc Thorac Surg. 2023;9(6):71-76. doi: 10.11648/j.ijcts.20230906.11

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  • @article{10.11648/j.ijcts.20230906.11,
      author = {Kémal Bori Bata and Arnaud Sonou and Hugues Dohou and Donald Aïkpon and Mayeul Agbo and Carmel Abatti and Maurice Dangbegnon and Murielle Hounkponou and Xavier Fadonougbo and Phillipe Agbalika and Francis Soummonni and David Dossou and Léopold Houétondji Codjo},
      title = {Acute Aortic Dissection at the Cardiology Clinic to the University National Hospital Hubert Koutoukou Maga of Cotonou (BENIN)},
      journal = {International Journal of Cardiovascular and Thoracic Surgery},
      volume = {9},
      number = {6},
      pages = {71-76},
      doi = {10.11648/j.ijcts.20230906.11},
      url = {https://doi.org/10.11648/j.ijcts.20230906.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcts.20230906.11},
      abstract = {Introduction: We aimed to describe epidemiological, diagnostic, therapeutic aspects of aortic dissection (AD) managed at the CNHU-HKM of Cotonou (Benin). Methods: It was a retrospective study from january 2018 to july 2023. All patients admitted for AD were enrolled. AD was classified as type A and type B according to Stanford. DA risk factors, socio-demographic characteristics and DA characteristics were studied. Results: Of the 2883 patients admitted during the study period, there were 17 cases of AD, representing a frequency of 0.6%. The mean age was 52 ± 9 years, and the sex ratio was 3.25. Uncontrolled hypertension was the predominant risk factor (88.3%). The main manifestations of AD were chest pain (100%) and aortic insufficiency (52.94%). Chest X-rays showed enlargement of the mediastinum in all patients. Echocardiography showed intimal flap in 62.5%. The aortic angiotomodensitometry, identified 12 type A (70.59%) and 5 type B (29.41%) of AD. Surgical or endovascular treatment was performed in 6 (35.29%) patients. Lethality rate was 47.06%. Conclusion: Aortic dissection was frequent at the teaching clinic of cardiology of CNHU-HKM of Cotonou. Surgical or endovascular treatment wasn't often available, and mortality was high. Prevention of this condition must be the rule, and it requires adequate management of hypertension, which is the most common risk factor.
    },
     year = {2023}
    }
    

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  • TY  - JOUR
    T1  - Acute Aortic Dissection at the Cardiology Clinic to the University National Hospital Hubert Koutoukou Maga of Cotonou (BENIN)
    AU  - Kémal Bori Bata
    AU  - Arnaud Sonou
    AU  - Hugues Dohou
    AU  - Donald Aïkpon
    AU  - Mayeul Agbo
    AU  - Carmel Abatti
    AU  - Maurice Dangbegnon
    AU  - Murielle Hounkponou
    AU  - Xavier Fadonougbo
    AU  - Phillipe Agbalika
    AU  - Francis Soummonni
    AU  - David Dossou
    AU  - Léopold Houétondji Codjo
    Y1  - 2023/12/06
    PY  - 2023
    N1  - https://doi.org/10.11648/j.ijcts.20230906.11
    DO  - 10.11648/j.ijcts.20230906.11
    T2  - International Journal of Cardiovascular and Thoracic Surgery
    JF  - International Journal of Cardiovascular and Thoracic Surgery
    JO  - International Journal of Cardiovascular and Thoracic Surgery
    SP  - 71
    EP  - 76
    PB  - Science Publishing Group
    SN  - 2575-4882
    UR  - https://doi.org/10.11648/j.ijcts.20230906.11
    AB  - Introduction: We aimed to describe epidemiological, diagnostic, therapeutic aspects of aortic dissection (AD) managed at the CNHU-HKM of Cotonou (Benin). Methods: It was a retrospective study from january 2018 to july 2023. All patients admitted for AD were enrolled. AD was classified as type A and type B according to Stanford. DA risk factors, socio-demographic characteristics and DA characteristics were studied. Results: Of the 2883 patients admitted during the study period, there were 17 cases of AD, representing a frequency of 0.6%. The mean age was 52 ± 9 years, and the sex ratio was 3.25. Uncontrolled hypertension was the predominant risk factor (88.3%). The main manifestations of AD were chest pain (100%) and aortic insufficiency (52.94%). Chest X-rays showed enlargement of the mediastinum in all patients. Echocardiography showed intimal flap in 62.5%. The aortic angiotomodensitometry, identified 12 type A (70.59%) and 5 type B (29.41%) of AD. Surgical or endovascular treatment was performed in 6 (35.29%) patients. Lethality rate was 47.06%. Conclusion: Aortic dissection was frequent at the teaching clinic of cardiology of CNHU-HKM of Cotonou. Surgical or endovascular treatment wasn't often available, and mortality was high. Prevention of this condition must be the rule, and it requires adequate management of hypertension, which is the most common risk factor.
    
    VL  - 9
    IS  - 6
    ER  - 

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Author Information
  • Cardiology Teaching and Research Unit and University Cardiology Clinic, National University Hospital Center Hubert Koutoukou Maga and Faculty of Health Sciences of Cotonou, Abomey Calavi, Benin

  • Cardiology Teaching and Research Unit and University Cardiology Clinic, National University Hospital Center Hubert Koutoukou Maga and Faculty of Health Sciences of Cotonou, Abomey Calavi, Benin

  • Cardiology Teaching and Research Unit Cardiology Department, Borgou/Alibori Departmental University Hospital Center Faculty of Medicine, Parakou, Benin

  • Cardiology Teaching and Research Unit and University Cardiology Clinic, National University Hospital Center Hubert Koutoukou Maga and Faculty of Health Sciences of Cotonou, Abomey Calavi, Benin

  • Cardiology Teaching and Research Unit and University Cardiology Clinic, National University Hospital Center Hubert Koutoukou Maga and Faculty of Health Sciences of Cotonou, Abomey Calavi, Benin

  • Cardiology Teaching and Research Unit and University Cardiology Clinic, National University Hospital Center Hubert Koutoukou Maga and Faculty of Health Sciences of Cotonou, Abomey Calavi, Benin

  • Cardiology Teaching and Research Unit and University Cardiology Clinic, National University Hospital Center Hubert Koutoukou Maga and Faculty of Health Sciences of Cotonou, Abomey Calavi, Benin

  • Cardiology Teaching and Research Unit and University Cardiology Clinic, National University Hospital Center Hubert Koutoukou Maga and Faculty of Health Sciences of Cotonou, Abomey Calavi, Benin

  • Cardiology Teaching and Research Unit and University Cardiology Clinic, National University Hospital Center Hubert Koutoukou Maga and Faculty of Health Sciences of Cotonou, Abomey Calavi, Benin

  • Cardiology Teaching and Research Unit and University Cardiology Clinic, National University Hospital Center Hubert Koutoukou Maga and Faculty of Health Sciences of Cotonou, Abomey Calavi, Benin

  • Cardiology Teaching and Research Unit and University Cardiology Clinic, National University Hospital Center Hubert Koutoukou Maga and Faculty of Health Sciences of Cotonou, Abomey Calavi, Benin

  • Cardiology Teaching and Research Unit and University Cardiology Clinic, National University Hospital Center Hubert Koutoukou Maga and Faculty of Health Sciences of Cotonou, Abomey Calavi, Benin

  • Cardiology Teaching and Research Unit and University Cardiology Clinic, National University Hospital Center Hubert Koutoukou Maga and Faculty of Health Sciences of Cotonou, Abomey Calavi, Benin

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