Abstract
Acute aortic dissection was first described by Dr. Nicholls, physician to the late king George II on necropsy over 200 years ago. Since that time, acute aortic dissection (AAD) continues to be one of the most feared pain syndromes because of its high morbidity and mortality. AAD poses a special challenge for physicians because of its relative rarity and its ability to mimic other more common conditions. With the high morbidity and mortality of AAD coupled with its relative low incidence, research in aortic dissection has largely been concentrated on single center registries enrolled over decades to allow for adequate numbers of patients for comparison and long term follow-up. However, the treatment for aortic dissection is a rapidly moving field with evolving surgical techniques, anesthesia, cardiopulmonary support, ICU and follow-up care. The urgency to collect data on larger numbers of patients over a shorter period of time was necessary to effectively describe the clinical course, management, and outcomes of this aggressive disease. In 1996, the International Registry of Acute Aortic Dissection (IRAD) was established with the mission to better understand the presentation, diagnosis, management, and outcomes of patients presenting with acute aortic dissection in the modern era. By 2000, over 450 patients had been enrolled from 12 international aortic referral centers. In the present report, we will review what IRAD has learned from these 2000 patients regarding the clinical presentation, prognosis, diagnostic imaging, therapeutic approaches and follow-up in the management of AAD. There is no comparable database available in the world that provides contemporary, multi-national outcomes data for surgical, endovascular and medical therapy in various forms of acute aortic syndromes. Thus, with contemporary information on acute aortic conditions, IRAD is unique and provides a valuable platform for modern strategic planning and teaching, and serves at the same time (on the scientific scope) as a hypothesis generating source of new information on an old disease.
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Christoph A. NienaberMD, FESC, FACC
Universitäres Herzzentrum Rostock
Abteilung für Innere Medizin
Universität Rostock
Ernst-Heydemann-Str. 6
18055 Rostock
eMail: christoph.nienaber@med.uni-rostock.de
