TY - JOUR
T1 - Effect of false lumen partial thrombosis on repaired acute type A aortic dissection
AU - Tsai, Meng Ta
AU - Wu, Hsuan Yin
AU - Roan, Jun Neng
AU - Tsai, Yi Shan
AU - Hsieh, Patrick C.H.
AU - Yang, Yu Jen
AU - Luo, Chwan Yau
N1 - Publisher Copyright:
© 2014 by The American Association for Thoracic Surgery.
PY - 2014/11/1
Y1 - 2014/11/1
N2 - Objective Studies on the partial thrombosis of a false lumen after repairing a type A acute aortic dissection (TAAAD) have reported conflicting results. We investigated the effects of a partially thrombosed false lumen on the segmental growth rates, distal aortic reoperations, and long-term survival.Conclusions Partial thrombosis at each segment of a residual false lumen after TAAAD repair correlated with a faster regional aortic growth rate and predicted a greater reoperation rate but did not affect long-term overall survival.Methods The postoperative computed tomography scans of 67 patients were retrospectively reviewed. A false lumen was independently defined at 3 segments of the descending thoracic aorta (DTA) on the last follow-up computed tomography scan: the proximal segment near the aortic arch, the distal segment near the diaphragm, and the middle segment.Results The segmental aortic growth rate of completely thrombosed, completely patent, and partially thrombosed false lumens was -0.10 ± 0.31, 0.09 ± 0.22, and 0.35 ± 0.60 mm/mo at the proximal DTA (P =.001), -0.04 ± 0.18, 0.12 ± 0.19, and 0.28 ± 0.28 mm/mo at the middle DTA (P <.001), and -0.02 ± 0.13, 0.07 ± 0.07, and 0.16 ± 0.14 mm/mo at the distal DTA (P <.001), respectively. The corresponding freedom from reoperation rates for the proximal DTA at 10 years were 100%, 88%, and 62% (P =.013). The overall 10-year survival rate was 89% and was not significantly different among the study groups.
AB - Objective Studies on the partial thrombosis of a false lumen after repairing a type A acute aortic dissection (TAAAD) have reported conflicting results. We investigated the effects of a partially thrombosed false lumen on the segmental growth rates, distal aortic reoperations, and long-term survival.Conclusions Partial thrombosis at each segment of a residual false lumen after TAAAD repair correlated with a faster regional aortic growth rate and predicted a greater reoperation rate but did not affect long-term overall survival.Methods The postoperative computed tomography scans of 67 patients were retrospectively reviewed. A false lumen was independently defined at 3 segments of the descending thoracic aorta (DTA) on the last follow-up computed tomography scan: the proximal segment near the aortic arch, the distal segment near the diaphragm, and the middle segment.Results The segmental aortic growth rate of completely thrombosed, completely patent, and partially thrombosed false lumens was -0.10 ± 0.31, 0.09 ± 0.22, and 0.35 ± 0.60 mm/mo at the proximal DTA (P =.001), -0.04 ± 0.18, 0.12 ± 0.19, and 0.28 ± 0.28 mm/mo at the middle DTA (P <.001), and -0.02 ± 0.13, 0.07 ± 0.07, and 0.16 ± 0.14 mm/mo at the distal DTA (P <.001), respectively. The corresponding freedom from reoperation rates for the proximal DTA at 10 years were 100%, 88%, and 62% (P =.013). The overall 10-year survival rate was 89% and was not significantly different among the study groups.
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U2 - 10.1016/j.jtcvs.2014.02.003
DO - 10.1016/j.jtcvs.2014.02.003
M3 - Article
C2 - 24656670
AN - SCOPUS:84911002190
VL - 148
SP - 2140-2146.e3
JO - Journal of Thoracic and Cardiovascular Surgery
JF - Journal of Thoracic and Cardiovascular Surgery
SN - 0022-5223
IS - 5
ER -