 |
|
| Effect of Partial Thrombosis on Distal Aorta after Repair of Acute DeBakey Type I Aortic Dissection | |
Suk-Won Song1, Byung-Chul Chang2, Bum-Koo Cho2, Kyung-Jong Yoo2; 1Yondong Severance Hospital, Yonsei University College of Medicine, Seoul, Korea, South; 2Severance Hospital, Yonsei University College of Medicine, Seoul, Korea, South
Methods: One hundred eighteen consecutive patients (55% male; mean age, 60 years) with acute DeBakey type I aortic dissection underwent aggressive resection of the intimal tear and open distal anastomosis (1997-2007). Hospital mortality was 17.8%. Survivors had serial computed tomographic scans: digitization yielded distal segmental dimensions. Segment-specific average rates of enlargement and factors influencing faster growth were analyzed. Distal reprocedures and patient survival were examined. Results: Sixty-six (61%) patients had imaging data sufficient for growth rate calculations. The median diameters after repair were as follows: aortic arch, 3.5 cm; descending aorta, 3.6 cm; and abdominal aorta, 2.4 cm. Subsequent growth rates were 0.34, 0.51, and 0.35 mm/y, respectively. Partial thrombosis of the residual aorta predicted greater growth in the distal aorta (p = 0.005). There were 13 distal aortic reprocedures (8 stent graft insertions, 5 reoperations) for 10 years, and reprocedures-free survival was 66%. Partial thrombosis (p = 0.002), or complete patency (p = 0.008) predicted greater risk of aorta-related reprocedures. Cox proportional hazard analysis revealed eGFR lesser than 60ml/min/1.73m2 (p = 0.030), reintubation (p = 0.002), and partial thrombosis (p = 0.023) were independent predictors for poor long-term outcome. Conclusion: Partial thrombosis of the false lumen after repair of acute DeBakey type I aortic dissection, as compared with complete patent or thrombosis, is a significant independent predictor of aortic enlargement, aorta-related reprocedures, and poor long-term outcome. Survivors who had partial thrombosis after repair of aortic dissection require meticulous and frequent follow-up due to a high risk of deterioration after discharge. 
Back to 2009 Annual Meeting Back to Program Outline Back to Main Program |
RSS Feeds
We Model Excellence |
|
Copyright © American Association for Thoracic Surgery. All rights reserved.
Read the Privacy Policy.
IMPORTANT REMINDER: The preceding information is intended only to provide
general guidance and not as a definitive basis for diagnosis or treatment in any particular case.
It is very important that you consult a doctor about any specific medical problem or question.
Read the Privacy Policy.
IMPORTANT REMINDER: The preceding information is intended only to provide
general guidance and not as a definitive basis for diagnosis or treatment in any particular case.
It is very important that you consult a doctor about any specific medical problem or question.