Understanding the impact of time on inflammation and post-repair aortic healing

Project Overview

Acute type A aortic dissection (ATAAD) is a medical emergency that requires immediate surgical repair. A rate of 1-2% mortality for the first 24 hours without treatment is commonly quoted. The reasons for poor outcomes in ATAAD are complex with patient presentation ranging from stable to critically ill depending on factors such as organ malperfusion.

In most cases, the amount of time between presentation and treatment is extremely important.

Unfortunately, the symptoms of ATAAD are varied and this often leads to a delayed diagnosis for frequent illnesses like acute coronary syndrome.

Inflammation is associated with ATAAD. A thorough analysis of current literature reveals that local tissue inflammation within the injured aorta wall is obvious, and elevated levels of systemic inflammatory indicators, such as the neutrophil to lymphocyte ratio, are linked to poorer clinical outcomes.

After tissue damage, an inflammatory reaction takes place. This is a dynamic process that rises to a peak before resolution and healing, which involves the gradual recruitment of various cells and proteins. Early tissue injury responders, neutrophils, can aggravate inflammation by producing neutrophil extracellular traps (NETs). The significance of this production in cardiovascular disorders is becoming increasingly apparent.

The management of dissection, including the timing of additional operations, depends on the healing of the aorta wall and dissection flap. The ability to predict postoperative healing and discover correlations between time to intervention and the inflammatory response may be achieved by understanding the profile of inflammatory biomarkers in the context of time.