Influence of Radiologically Evident Residual Intimal Tear on Expansion of Descending Aorta Following Surgery for Acute Type I Aortic Dissection
The Korean Journal of Thoracic and Cardiovascular Surgery
;
: 6-12, 2014.
Article
in English
| WPRIM
| ID: wpr-29899
ABSTRACT
BACKGROUND:
Although a residual intimal tear may contribute to the dilatation of the descending aorta following surgical repair of acute type I aortic dissection (AD), its causal relationship has not been elucidated by clinical data due to the limited resolution of imaging modalities.METHODS:
This study enrolled 41 patients (age, 55.2+/-11.9 years) who were evaluated with dual-source computed tomography (CT) imaging of the whole aorta in the setting of the surgical repair of acute type I AD. Logistic regression models were used to determine the predictors of a composite of the aortic aneurysm formation (diameter >55 mm) and rapid aortic expansion (>5 mm/yr).RESULTS:
On initial CT, a distal re-entry tear was identified in 9 patients. Two patients failed to achieve proximal tear exclusion by the surgery. Serial follow-up CT evaluations (median, 24.6 months; range, 6.0 to 67.2 months) revealed that 14 patients showed rapid expansion of the descending aorta or aortic aneurysm formation. A multivariate analysis revealed that the residual intimal tear (odds ratio [OR], 4.31; 95% confidence interval [CI], 1.02 to 19.31) and the patent false lumen in the early postoperative setting (OR, 4.64; 95% CI, 0.99 to 43.61) were predictive of the composite endpoint.CONCLUSION:
The presence of a residual intimal tear following surgery for acute type I AD adversely influenced the expansion of the descending aorta.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Aorta
/
Aorta, Thoracic
/
Aortic Aneurysm
/
Logistic Models
/
Multivariate Analysis
/
Follow-Up Studies
/
Dilatation
/
Aneurysm
Type of study:
Observational study
/
Prognostic study
/
Risk factors
Limits:
Humans
Language:
English
Journal:
The Korean Journal of Thoracic and Cardiovascular Surgery
Year:
2014
Type:
Article
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