Ratio of the False Lumen to the True Lumen is Associated with Long-term Prognosis After Surgical Repair of Acute Type A Aortic Dissection

Overview

Journal JTCVS Open

Specialty Cardiology & Vascular Diseases

Date 2022 Aug 25

PMID 36004215

Authors

Takashi Igarashi

Yoichi Sato

Hirono Satokawa

Shinya Takase

Masumi Iwai-Takano

Yuki Seto

Hitoshi Yokoyama

Affiliations

Soon will be listed here.

Abstract

Objectives: The aim of this study was to assess potential predictors of aortic events after an emergency surgery for acute type A aortic dissection, especially paying attention to the findings of computed tomography (CT) performed immediately after the surgery.

Methods: Between January 2001 and December 2015, 72 patients, who were diagnosed as having Stanford type A acute aortic dissection with a patent false lumen in the descending thoracic aorta, survived the emergency operation, and had postoperative CT scan data, were included in this study (mean follow-up, 8.2 ± 3.8 years; range 0.8-17.4 years). From the CT scan data, the diameter of the false lumen (FL-D) and true lumen (TL-D) were measured, and the FL-D:TL-D ratio was calculated. Long-term outcomes of the FL-D > TL-D group (n = 30) and the FL-D < TL-D group (n = 42) were compared.

Results: In the late follow-up, 17 aortic events in the downstream aorta were observed. The FL-D:TL-D ratio ( = .01) was an adjusted risk of aortic events in multivariable analysis. The rates of freedom from aortic events at 5 and 9 years were superior in the FL-D < TL-D group than in the FL-D > TL-D group (92.0% and 88.6% vs 81% and 60.7%; log rank < .05).

Conclusions: Our results suggest that the false lumen:true lumen ratio predicts long-term prognosis after surgical repair of acute type A aortic dissection.

Citing Articles

Finite-element simulation of in-plane tear propagation in the dissected aorta: Implications for the propagation mechanism.

Han H, Guo B, Gao P, Yang F, Sun C, Hill N Int J Numer Method Biomed Eng. 2023; 39(9):e3743.

PMID: 37344920 PMC: 10909461. DOI: 10.1002/cnm.3743.

Commentary: The correct answer is not true or false, but the ratio might be.

Atkins M, Reardon M JTCVS Open. 2022; 10:85-86.

PMID: 36004227 PMC: 9390742. DOI: 10.1016/j.xjon.2022.04.005.

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