Identified the importance of Marfan’s syndrome, bicuspid aortic valve, and aortic enlargement in young patients.Įstablished partial thrombosis as a predictor of poor post-discharge prognosis.ĭemonstrated that many dissections occur before accepted size criteria are achieved.ĭemonstrated the high sensitivity of d-dimer elevation in detecting aortic dissection.ĭemonstrated the benefit of beta-blockers and lack of benefit of ACE inhibitors.Ĭalled attention to cocaine as an important etiological factor for acute aortic dissection in the present era.ĪCE = angiotensin-converting enzyme CT = computed tomography IRAD = International Registry of Acute Aortic Dissection MRI = magnetic resonance imaging TEE = transesophageal echocardiography. Journal of the American College of Cardiology Journal of the American Medical Associationĭescribed manifestations of acute aortic dissection.ĭemonstrated high sensitivity for all 4 imaging techniques: CT, MRI, TEE, and angiography.ĭescribed circadian and seasonal variations in incidence. 10 Most Important Contributions by IRAD (Among Many Others) First Author, Year of Publication (Ref. We consider the publications listed in Table 1 to be among the 10 most important contributions by IRAD. These publications have permitted us to “feel the elephant” that is aortic dissection. We identified 61 major scientific papers written by the IRAD group between 20 ( Online Table 1). Kim Eagle, Christophe Nienaber, and Eric Isselbacher, represented a brilliant brainchild that has contributed immensely to the advancement of care in management of aortic diseases. The conception and implementation of the IRAD database and project in 1996, under the direction of Drs. Hospital mortality improved for type A aortic dissection but not for type B. Surgical results for type A and type B aortic dissection improved.Įndovascular therapies were applied increasingly for type B dissection.īeta-blockers, angiotensin receptor blockers (ARBs), diuretics, and statins were prescribed more frequently at hospital discharge following acute aortic dissection.
The role of chest x-rays in diagnosis of acute dissection diminished. Use of computed tomography (CT) as the diagnostic modality increased. Ĭlinical presentation of acute aortic dissection did not change.They found that the following occurred between 19: (1) from the International Registry of Acute Aortic Dissection (IRAD) group analyzed trends in the presentation, diagnosis, and outcomes of aortic dissection over the 17-year history of IRAD. In this issue of the Journal, Pape et al.
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