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Bjursten H, Oudin Åström D, Nozohoor S, et al. Once after a full moon: acute type A aortic dissection and lunar phases. Interact Cardiovasc Thorac Surg. 2021;doi: 10.1093/icvts/ivab220.
Bjursten, H., Oudin Åström, D., Nozohoor, S., Ahmad, K., Tang, M., Bjurbom, M., Hansson, E. C., Jeppsson, A., Joost Holdflod Møller, C., Jormalainen, M., Juvonen, T., Mennander, A., Olsen, P. S., Olsson, C., Ahlsson, A., Oudin, A., Pan, E., Raivio, P., Wickbom, A., Sjögren, J., Geirsson, A., Gudbjartsson, T., & Zindovic, I. (2021). Once after a full moon: acute type A aortic dissection and lunar phases. Interactive cardiovascular and thoracic surgery, . https://doi.org/10.1093/icvts/ivab220
Bjursten, Henrik, et al. "Once after a full moon: acute type A aortic dissection and lunar phases." Interactive cardiovascular and thoracic surgery vol. (2021). doi: https://doi.org/10.1093/icvts/ivab220
Bjursten H, Oudin Åström D, Nozohoor S, Ahmad K, Tang M, Bjurbom M, Hansson EC, Jeppsson A, Joost Holdflod Møller C, Jormalainen M, Juvonen T, Mennander A, Olsen PS, Olsson C, Ahlsson A, Oudin A, Pan E, Raivio P, Wickbom A, Sjögren J, Geirsson A, Gudbjartsson T, Zindovic I. Once after a full moon: acute type A aortic dissection and lunar phases. Interact Cardiovasc Thorac Surg. 2021 Aug 27; doi: 10.1093/icvts/ivab220. Epub 2021 Aug 27. PMID: 34450636.
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Interact Cardiovasc Thorac Surg. 2021 Aug 27; doi: 10.1093/icvts/ivab220. Epub 2021 Aug 27.

Once after a full moon: acute type A aortic dissection and lunar phases.

Interactive cardiovascular and thoracic surgery

Henrik Bjursten, Daniel Oudin Åström, Shahab Nozohoor, Khalil Ahmad, Mariann Tang, Markus Bjurbom, Emma C Hansson, Anders Jeppsson, Christian Joost Holdflod Møller, Miko Jormalainen, Tatu Juvonen, Ari Mennander, Peter S Olsen, Christian Olsson, Anders Ahlsson, Anna Oudin, Emily Pan, Peter Raivio, Anders Wickbom, Johan Sjögren, Arnar Geirsson, Tomas Gudbjartsson, Igor Zindovic

Affiliations

  1. Department of Cardiothoracic Surgery, Lund University, Skåne University Hospital, Lund, Sweden.
  2. Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden.
  3. Division of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
  4. Department of Thoracic and Cardiovascular Surgery, Aarhus University Hospital, Skejby, Denmark.
  5. Department of Thoracic and Cardiovascular Surgery, Karolinska University Hospital, Stockholm, Sweden.
  6. Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
  7. Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
  8. Department of Cardiothoracic Surgery, The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
  9. Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland.
  10. Research Unit of Surgery, Anesthesia, and Critical Care, University of Oulu, Oulu, Finland.
  11. Heart Centre, Tampere University Hospital and University of Tampere, Tampere, Finland.
  12. Department of Cardiothoracic Surgery, Centre for Cardiac, Vascular, Pulmonary and Infectious Diseases, Rigshospitalet, Copenhagen, Denmark.
  13. Department of Surgery, Central Finland Central Hospital, Jyväskylä, Finland.
  14. Turku University Hospital, Turku, Finland.
  15. Department of Cardiothoracic and Vascular Surgery, Orebro University Hospital and Faculty of Medicine and Health, Orebro University, Orebro, Sweden.
  16. Section of Cardiac Surgery, Yale University School of Medicine, New Haven, CT, USA.
  17. Department of Cardiothoracic Surgery, Landspitali University Hospital and Faculty of Medicine, University of Iceland, Reykjavik, Iceland.

PMID: 34450636 DOI: 10.1093/icvts/ivab220

Abstract

OBJECTIVES: Acute type A aortic dissection (ATAAD) is a rare but severe condition, routinely treated with emergent cardiac surgery. Many surgeons have the notion that patients with ATAAD tend to come in clusters, but no studies have examined these observations. This investigation was undertaken to study the potential association between the lunar cycle and the incidence of ATAAD.

METHODS: We collected information on 2995 patients who underwent ATAAD surgery at centres from the Nordic Consortium for Acute Type A Aortic Dissection collaboration. We cross-referenced the time of surgery with lunar phase using a case-crossover design with 2 different definitions of full moon (>99% illumination and the 7-day full moon period).

RESULTS: The period when the moon was illuminated the most (99% definition) did not show any significant increase in incidence for ATAAD surgery. However, when the full moon period was compared with all other moon phases, it yielded a relative risk of 1.08 [95% confidence interval (CI) 1.00-1.17, P = 0.057] and, compared to waxing moon, only the relative risk was 1.11 (95% CI 1.01-1.23, P = 0.027). The peak incidence came 4-6 days after the moon was fully illuminated.

CONCLUSIONS: This study found an overrepresentation of surgery for ATAAD during the full moon phase. The explanation for this is not known, but we speculate that sleep deprivation during full moon leads to a temporary increase in blood pressure, which in turn could trigger rupture of the aortic wall. While this finding is interesting, it needs to be corroborated and the clinical implications are debateable.

© The Author(s) 2021. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Keywords: Dissection of the aorta; Moon

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