E-ISSN 2146-8133
 

Original Research (Original Article) 


Effects of psychiatric disorders on Type A acute aortic dissection pathogenesis and analysis of follow-up results

Paolo Nardi, Antonio Pellegrino, Francesco Bianchi, Marco Russo, Guglielmo Saitto, Piero Caporali, Francesca D’Auria, Alberto Siracusano, Giovanni Ruvolo, Luigi Chiariello.

Abstract
Aims: A connection between psychiatric disorders (PDs) and Type A acute aortic dissection (AAD) has not been shown. The aim of this study was to define the psychological profile of patients treated for AAD, and to analyze the prevalence of PDs in their medical histories, in the immediate postoperative period, and at a mid-term follow-up.
Patients and Methods: From March 2005 to October 2014, 240 consecutive patients underwent surgery for AAD. 60 patients (mean age 60±13 years; 43 males) underwent psychiatric consultation postoperatively, and they represent the subjects of our retrospective study. Ascending aorta ± arch replacement was performed in 43 patients, whereas the Bentall procedure ± arch replacement was performed in 17. Data were retrospectively analyzed. Follow-ups were completed in 59 patients (mean duration 35±23 months).
Results: PDs were present in the medical histories of 34 patients. Postoperatively, in 28 cases, a definitive diagnosis of PD (group PD) was made in agreement with the diagnostic and statistical manual of mental disorders-IV criteria, including: Major depression (n=13), anxious-depressive syndrome (n=6), bipolar disorder Type 2 (n=4), panic attacks (n=2), paranoid schizophrenia (n=1), and anxiety (n=2). 32 patients without a definitive psychiatric diagnosis were classified as Group non-PD. In the postoperative period, clinical manifestations of PDs, including delirium, persistent spatio-temporal disorientation, and psychomotor agitation were evident in 22 patients (78%) in group PD versus 8 patients (25%) in group non-PD (P<0.0001). During follow-up, only one death for non-cardiac reasons occurred in group PD. There were no suicides; only 10 patients of group PD required PD treatment (P<0.0001 vs. early postoperative findings); 4 patients in group non-PD required PD treatment.
Conclusion: Our findings suggest a strong relationship between PD and AAD. Because the psychiatric conditions appeared to be largely stable after surgery, treatment of AAD for patients affected by PDs seemed to represent the first step to detect their PDs and to start an appropriate medical therapy.

Key words: Acute aortic dissection, aortic surgery, psychiatric disorders


 
ARTICLE TOOLS
Abstract
PDF Fulltext
Print this article Print this Article
How to cite this articleHow to cite this article
Export to
Export to
Related Records
 Articles by Paolo Nardi
Articles by Antonio Pellegrino
Articles by Francesco Bianchi
Articles by Marco Russo
Articles by Guglielmo Saitto
Articles by Piero Caporali
Articles by Francesca D’Auria
Articles by Alberto Siracusano
Articles by Giovanni Ruvolo
Articles by Luigi Chiariello
on Google
on Google Scholar
Article Statistics
 Viewed: 1359
Downloaded: 414
Cited: 0

REFERENCES
1. Frasure-Smith N, LespĂ©rance F, Talajic M. Depression following myocardial infarction. Impact on 6-month survival. JAMA 1993;270:1819-25. [DOI via Crossref]    [Pubmed]   
2. Halaris A. Comorbidity between depression and cardiovascular disease. Int Angiol 2009;28:92-9. [Pubmed]   
3. Pizzi C, Santarella L, Manfrini O, Chiavaroli M, Agushi E, Cordioli E, et al. Ischemic heart disease and depression: An underestimated clinical association. G Ital Cardiol (Rome) 2013;14:526-37.
4. Rumsfeld JS, Ho PM. Depression and cardiovascular disease: A call for recognition. Circulation 2005;111:250-3. [DOI via Crossref]    [Pubmed]   
5. Frasure-Smith N, LespĂ©rance F, Talajic M. Depression and 18-month prognosis after myocardial infarction. Circulation 1995;91:999-1005. [DOI via Crossref]    [Pubmed]   
6. LespĂ©rance F, Frasure-Smith N, Juneau M, ThĂ©roux P. Depression and 1-year prognosis in unstable angina. Arch Intern Med 2000;160:1354-60. [DOI via Crossref]    [Pubmed]   
7. Mallik S, Krumholz HM, Lin ZQ, Kasl SV, Mattera JA, Roumains  SA, et al.Patients with depressive symptoms have lower health status benefits after coronary artery bypass surgery. Circulation 2005;111:271-7. [DOI via Crossref]    [Pubmed]   
8. Pignay-Demaria V, LespĂ©rance F, Demaria RG, Frasure-Smith N, Perrault LP. Depression and anxiety and outcomes of coronary artery bypass surgery. Ann Thorac Surg 2003;75:314-21. [DOI via Crossref]   
9. Connerney I, Shapiro PA, McLaughlin JS, Bagiella E, Sloan RP. Relation between depression after coronary artery bypass surgery and 12-month outcome: A prospective study. Lancet 2001;358:1766-71. [DOI via Crossref]   
10. Blumenthal JA, Lett HS, Babyak MA, White W, Smith PK, Mark DB, et al. Depression as a risk factor for mortality after coronary artery bypass surgery. Lancet 2003;362:604-9. [DOI via Crossref]   
11. Pizzi C, Manzoli L, Mancini S, Bedetti G, Fontana F, Costa GM. Autonomic nervous system, inflammation and preclinical carotid atherosclerosis in depressed subjects with coronary risk factors. Atherosclerosis 2010;212:292-8. [DOI via Crossref]    [Pubmed]   
12. Carney RM, Blumenthal JA, Stein PK, Watkins L, Catellier D, Berkman  LF, et al. Depression, heart rate variability, and acute myocardial infarction. Circulation 2001;104:2024-8. [DOI via Crossref]    [Pubmed]   
13. Murr C, Ledochowski M, Fuchs D. Chronic immune stimulation may link ischemic heart disease with depression. Circulation 2002;105:e83. [DOI via Crossref]    [Pubmed]   
14. Eker SS, Akkaya C, Cangur S, Yuvank U, Sarandol A, Kirli S. The effects of reboxetine and venlafaxine on ECG variables in depressed patients. Bull Clin Psychopharmacol 2011;21:11-7. [DOI via Crossref]   
15. Tsai TT, Nienaber CA, Eagle KA. Acute aortic syndromes. Circulation 2005;112:3802-13. [DOI via Crossref]    [Pubmed]   
16. Hiratzka LF, Bakris GL, Beckman JA, Bersin RM, Carr VF, Casey DE Jr, et al. Guidelines for the diagnosis and management of patients with thoracic aorta disease. Circulation 2010;121:e266-369. [Pubmed]   
17. Daniel JC, Huynh TT, Zhou W, Kougias P, El Sayed HF, Huh J, et al. Acute aortic dissection associated with use of cocaine. J Vasc Surg 2007;46:427-33. [DOI via Crossref]    [Pubmed]   
18. Westover AN, Nakonezny PA. Aortic dissection in young adults who abuse amphetamines. Am Heart J 2010;160:315-21. [DOI via Crossref]    [Pubmed]    [PMC Free Fulltext]   
19. Swalwell CI, Davis GG. Methamphetamine as a risk factor for acute aortic dissection. J Forensic Sci 1999;44:23-6. [DOI via Crossref]    [Pubmed]   
20. Shiraishi M, Ohki S, Muraoka A, Aizawa K, Sakano Y, Kaminishi Y, et  al. Analysis of perioperative factors for neurological dysfunction in patients with thoracic aortic surgery. Arch Clin Exp Surg 2013;2:141-8.
21. Gladigau EL, Fazio TN, Hannam JP, Dawson LM, Jones SG. Increased cardiovascular risk in patients with severe mental illness. Intern Med J 2014;44:65-9. [DOI via Crossref]    [Pubmed]   
22. Smith DJ, Martin D, McLean G, Langan J, Guthrie B, Mercer SW. Multimorbidity in bipolar disorder and undertreatment of cardiovascular disease: a cross sectional study. BMC Med 2013;11:263. [DOI via Crossref]    [Pubmed]    [PMC Free Fulltext]   

How to Cite this Article
Pubmed Style

Nardi P, Pellegrino A, Bianchi F, Russo M, Saitto G, Caporali P, D'Auria F, Siracusano A, Ruvolo G, Chiariello L. Effects of psychiatric disorders on Type A acute aortic dissection pathogenesis and analysis of follow-up results. Arch Clin Exp Surg. 2015; 4(4): 202-207. doi:10.5455/aces.20150108115200


Web Style

Nardi P, Pellegrino A, Bianchi F, Russo M, Saitto G, Caporali P, D'Auria F, Siracusano A, Ruvolo G, Chiariello L. Effects of psychiatric disorders on Type A acute aortic dissection pathogenesis and analysis of follow-up results. http://www.ejmaces.com/?mno=173834 [Access: August 17, 2018]. doi:10.5455/aces.20150108115200


AMA (American Medical Association) Style

Nardi P, Pellegrino A, Bianchi F, Russo M, Saitto G, Caporali P, D'Auria F, Siracusano A, Ruvolo G, Chiariello L. Effects of psychiatric disorders on Type A acute aortic dissection pathogenesis and analysis of follow-up results. Arch Clin Exp Surg. 2015; 4(4): 202-207. doi:10.5455/aces.20150108115200



Vancouver/ICMJE Style

Nardi P, Pellegrino A, Bianchi F, Russo M, Saitto G, Caporali P, D'Auria F, Siracusano A, Ruvolo G, Chiariello L. Effects of psychiatric disorders on Type A acute aortic dissection pathogenesis and analysis of follow-up results. Arch Clin Exp Surg. (2015), [cited August 17, 2018]; 4(4): 202-207. doi:10.5455/aces.20150108115200



Harvard Style

Nardi, P., Pellegrino, A., Bianchi, F., Russo, M., Saitto, G., Caporali, P., D'Auria, F., Siracusano, A., Ruvolo, G. & Chiariello, L. (2015) Effects of psychiatric disorders on Type A acute aortic dissection pathogenesis and analysis of follow-up results. Arch Clin Exp Surg, 4 (4), 202-207. doi:10.5455/aces.20150108115200



Turabian Style

Nardi, Paolo, Antonio Pellegrino, Francesco Bianchi, Marco Russo, Guglielmo Saitto, Piero Caporali, Francesca D'Auria, Alberto Siracusano, Giovanni Ruvolo, and Luigi Chiariello. 2015. Effects of psychiatric disorders on Type A acute aortic dissection pathogenesis and analysis of follow-up results. Archives of Clinical and Experimental Surgery (ACES), 4 (4), 202-207. doi:10.5455/aces.20150108115200



Chicago Style

Nardi, Paolo, Antonio Pellegrino, Francesco Bianchi, Marco Russo, Guglielmo Saitto, Piero Caporali, Francesca D'Auria, Alberto Siracusano, Giovanni Ruvolo, and Luigi Chiariello. "Effects of psychiatric disorders on Type A acute aortic dissection pathogenesis and analysis of follow-up results." Archives of Clinical and Experimental Surgery (ACES) 4 (2015), 202-207. doi:10.5455/aces.20150108115200



MLA (The Modern Language Association) Style

Nardi, Paolo, Antonio Pellegrino, Francesco Bianchi, Marco Russo, Guglielmo Saitto, Piero Caporali, Francesca D'Auria, Alberto Siracusano, Giovanni Ruvolo, and Luigi Chiariello. "Effects of psychiatric disorders on Type A acute aortic dissection pathogenesis and analysis of follow-up results." Archives of Clinical and Experimental Surgery (ACES) 4.4 (2015), 202-207. Print. doi:10.5455/aces.20150108115200



APA (American Psychological Association) Style

Nardi, P., Pellegrino, A., Bianchi, F., Russo, M., Saitto, G., Caporali, P., D'Auria, F., Siracusano, A., Ruvolo, G. & Chiariello, L. (2015) Effects of psychiatric disorders on Type A acute aortic dissection pathogenesis and analysis of follow-up results. Archives of Clinical and Experimental Surgery (ACES), 4 (4), 202-207. doi:10.5455/aces.20150108115200





Most Viewed Articles
  • Hirudotherapy /Leech therapy: Applications and Indications in Surgery
    Swaid Abdullah, Latief M. Dar, Adil Rashid, Anita Tewari
    Arch Clin Exp Surg. 2012; 1(3): 172-180
    » Abstract & References » doi: 10.5455/aces.20120402072447

  • Role of Probiotics in Dental Caries and Periodontal Disease
    Amit Bhardwaj, Shalu V Bhardwaj
    Arch Clin Exp Surg. 2012; 1(1): 45-49
    » Abstract & References » doi: 10.5455/aces.20120212100645

  • Attenuated familial adenomatous polyposis presenting as an abdominal wall mass
    Marc Paul Jose Lopez, John Paul Senon Gonzalez, Manuel Francisco Tanada Roxas
    Arch Clin Exp Surg. 2017; 6(1): 53-55
    » Abstract » doi: 10.5455/aces.20150809085449

  • Use of Polyethylene Fiber (Ribbond) in Pediatric Dentistry
    Eda Arat Maden, Ceyhan Altun
    Arch Clin Exp Surg. 2012; 1(2): 110-115
    » Abstract & References » doi: 10.5455/aces.20120416115640

  • Role of Ultrasonography (“Honeycomb Sign”) in Early Detection of Dengue Hemorrhagic Fever
    Sudhir Sachar, Sunder Goyal, Saurabh Sachar
    Arch Clin Exp Surg. 2013; 2(1): 38-42
    » Abstract & References » doi: 10.5455/aces.20120828025157

  • Barium Enema in the Diagnosis of Hirschsprung’s Disease: A Comparison with Rectal Biopsy
    Mohammad Abbas, Arshad Rashid, Asim Rafiq Laharwal, Ajaz Ahmad Wani, Shabir Ahmad Dar, Manzoor Ahamad Chalkoo, Showkat Majeed Kakroo
    Arch Clin Exp Surg. 2013; 2(4): 224-228
    » Abstract & References » doi: 10.5455/aces.20120703031135

  • Long-Term Productive Cough Caused by Tracheal Bronchus
    Chih-Hao Chen, Shih-Yi Lee, Ho Chang, Tzu-Ti Hung
    Arch Clin Exp Surg. 2012; 1(2): 120-121
    » Abstract & References » doi: 10.5455/aces.20120311102403

  • A Review of the Prevention and Treatment of Hypertrophic Scars: Part I Clinical Aspects
    Huseyin Karagoz, Celalettin Sever, Yalcin Bayram, Cihan Sahin, Yalcin Kulahci, Ersin Ulkur
    Arch Clin Exp Surg. 2012; 1(4): 237-248
    » Abstract & References » doi: 10.5455/aces.20120218124923

  • Day–Care Surgery for Pilonidal Sinus Using Sinotomy Technique and Fibrin Glue Injection
    Selim Sozen, Vedat Ozturk, Koray Das, Hasan Erdem, Suleyman Cetinkunar, Ilhan Bali
    Arch Clin Exp Surg. 2012; 1(3): 138-141
    » Abstract & References » doi: 10.5455/aces.20120625121721

  • Patient Selection in Plastic Surgery: Recognizing Body Dysmorphic Disorder
    Cihan Sahin, Onat Yilmaz, Yalcin Bayram, Huseyin Karagoz, Celalettin Sever, Yalcin Kulahci, Alpay Ates
    Arch Clin Exp Surg. 2013; 2(2): 109-115
    » Abstract & References » doi: 10.5455/aces.20120722123102

  • Most Downloaded
  • Attenuated familial adenomatous polyposis presenting as an abdominal wall mass
    Marc Paul Jose Lopez, John Paul Senon Gonzalez, Manuel Francisco Tanada Roxas
    Arch Clin Exp Surg. 2017; 6(1): 53-55
    » Abstract » doi: 10.5455/aces.20150809085449

  • Role of Probiotics in Dental Caries and Periodontal Disease
    Amit Bhardwaj, Shalu V Bhardwaj
    Arch Clin Exp Surg. 2012; 1(1): 45-49
    » Abstract & References » doi: 10.5455/aces.20120212100645

  • Patient Selection in Plastic Surgery: Recognizing Body Dysmorphic Disorder
    Cihan Sahin, Onat Yilmaz, Yalcin Bayram, Huseyin Karagoz, Celalettin Sever, Yalcin Kulahci, Alpay Ates
    Arch Clin Exp Surg. 2013; 2(2): 109-115
    » Abstract & References » doi: 10.5455/aces.20120722123102

  • Hirudotherapy /Leech therapy: Applications and Indications in Surgery
    Swaid Abdullah, Latief M. Dar, Adil Rashid, Anita Tewari
    Arch Clin Exp Surg. 2012; 1(3): 172-180
    » Abstract & References » doi: 10.5455/aces.20120402072447

  • Use of Polyethylene Fiber (Ribbond) in Pediatric Dentistry
    Eda Arat Maden, Ceyhan Altun
    Arch Clin Exp Surg. 2012; 1(2): 110-115
    » Abstract & References » doi: 10.5455/aces.20120416115640

  • A Study of Methods Used to Reduce Surgical Site Infections
    Stuart R. Walker, Tara Anderson
    Arch Clin Exp Surg. 2012; 1(1): 27-33
    » Abstract & References » doi: 10.5455/aces.20120213053645

  • Principles of risk management in surgery departments
    Fatemeh Rezaei, Mohammad H Yarmohammadian, Masoud Ferdosi, Abbas Haghshenas
    Arch Clin Exp Surg. 2015; 4(3): 126-134
    » Abstract & References » doi: 10.5455/aces.20140925015830

  • Slow-Release Drug Deliver System with Polylactic Acid Hydrogels in Prevention of Tracheal Wall Fibroplasia
    Jinrang Li, Lili Peng, Jianjun Sun, Hongguang Guo, Kun Guo, Zuogang Li, Yao Tang, Xu Sun, Shuangqing Zhang
    Arch Clin Exp Surg. 2012; 1(1): 1-7
    » Abstract & References » doi: 10.5455/aces.20120220105531

  • Post-Traumatic Pancreatic Pseudocyst: Report of Two Cases with Review of Literature
    Sunder Goyal, Sudhir Sachar, Ram Kumar Verma, Snigdha Goyal
    Arch Clin Exp Surg. 2013; 2(4): 251-258
    » Abstract & References » doi: 10.5455/aces.20120524103614

  • Role of Ultrasonography (“Honeycomb Sign”) in Early Detection of Dengue Hemorrhagic Fever
    Sudhir Sachar, Sunder Goyal, Saurabh Sachar
    Arch Clin Exp Surg. 2013; 2(1): 38-42
    » Abstract & References » doi: 10.5455/aces.20120828025157

  • Most Cited Articles
  • Hirudotherapy /Leech therapy: Applications and Indications in Surgery
    Swaid Abdullah, Latief M. Dar, Adil Rashid, Anita Tewari
    Arch Clin Exp Surg. 2012; 1(3): 172-180
    » Abstract & References » doi: 10.5455/aces.20120402072447
    Cited : 8 times [Click to see citing articles]

  • Experimental Craniofacial Composite Tissue Allotransplantation (CCTA) Models in Rats
    Yalcin Kulahci, Yalcin Bayram, Huseyin Karagoz, Celalettin Sever, Cihan Sahin
    Arch Clin Exp Surg. 2012; 1(3): 181-187
    » Abstract & References » doi: 10.5455/aces.20120514010906
    Cited : 7 times [Click to see citing articles]

  • Thoracodorsal Artery Perforator Flap: Basic Surgical Determinants
    Celalettin Sever, Yalcin Bayram, Cihan Sahin
    Arch Clin Exp Surg. 2012; 1(4): 270-271
    » Abstract & References » doi: 10.5455/aces.20120506072849
    Cited : 6 times [Click to see citing articles]

  • Pre-expanded Supraclavicular Flap for Post-burn Neck Contractures
    Celalettin Sever, Cihan Sahin
    Arch Clin Exp Surg. 2012; 1(1): 61-62
    » Abstract & References » doi: 10.5455/aces.20120205090034
    Cited : 4 times [Click to see citing articles]

  • Day–Care Surgery for Pilonidal Sinus Using Sinotomy Technique and Fibrin Glue Injection
    Selim Sozen, Vedat Ozturk, Koray Das, Hasan Erdem, Suleyman Cetinkunar, Ilhan Bali
    Arch Clin Exp Surg. 2012; 1(3): 138-141
    » Abstract & References » doi: 10.5455/aces.20120625121721
    Cited : 4 times [Click to see citing articles]

  • The effect of Kristeller maneuver on maternal and neonatal outcome
    Gokhan Acmaz, Evrim Albayrak, Gokalp Oner, Murvet Baser, Gulsum Aykut, Gulender Tas Tekin, Gokmen Zararsiz, Iptisam Ipek Muderris
    Arch Clin Exp Surg. 2015; 4(1): 29-35
    » Abstract & References » doi: 10.5455/aces.20140328024258
    Cited : 4 times [Click to see citing articles]

  • What is the Most Appropriate Animal Model for Experimental Diabetic Neuropathy Studies ?
    Huseyin Karagoz, Mustafa Tansel Kendirli
    Arch Clin Exp Surg. 2012; 1(3): 199-200
    » Abstract & References » doi: 10.5455/aces.20120514012617
    Cited : 3 times [Click to see citing articles]

  • Anesthetic Burns – A Burn Injury Due to A Combination of Local Anaesthetic and Heat Pack
    Stuart Robert Walker
    Arch Clin Exp Surg. 2012; 1(2): 127-128
    » Abstract & References » doi: 10.5455/aces.20120206110836
    Cited : 3 times [Click to see citing articles]

  • A Review of the Prevention and Treatment of Hypertrophic Scars: Part I Clinical Aspects
    Huseyin Karagoz, Celalettin Sever, Yalcin Bayram, Cihan Sahin, Yalcin Kulahci, Ersin Ulkur
    Arch Clin Exp Surg. 2012; 1(4): 237-248
    » Abstract & References » doi: 10.5455/aces.20120218124923
    Cited : 3 times [Click to see citing articles]

  • A Review of the Prevention and Treatment of Hypertrophic Scars: Part II. Experimental Studies
    Huseyin Karagoz, Yalcin Bayram, Celalettin Sever, Cihan Sahin, Yalcin Kulahci, Ersin Ulkur
    Arch Clin Exp Surg. 2013; 2(1): 49-58
    » Abstract & References » doi: 10.5455/aces.20120218125115
    Cited : 3 times [Click to see citing articles]