Related Experiment Videos
Is conservative therapy acceptable for thrombosed type A acute aortic dissection?
Yasushige Shingu1, Kazuhiro Myojin, Yoshimitsu Ishibashi
1Division of Cardiovascular Surgery, National Sapporo Hospital, 4-2, Kikusui, Shiroishiku, Sapporo 003-0804, Japan.
The Japanese Journal of Thoracic and Cardiovascular Surgery : Official Publication of the Japanese Association for Thoracic Surgery = Nihon Kyobu Geka Gakkai Zasshi
|November 19, 2003
Summary
Conservative therapy is a viable option for thrombosed type A aortic dissection. A smaller false lumen to true lumen ratio and stable aneurysm size indicate suitability for non-operative management.
Area of Science:
- Cardiovascular Surgery
- Vascular Medicine
- Aortic Diseases
Background:
- Thrombosed type A aortic dissection management remains controversial.
- Surgical intervention carries risks, prompting evaluation of conservative approaches.
Purpose of the Study:
- To assess the efficacy of conservative therapy for thrombosed type A aortic dissection.
- To identify morphological predictors for surgical intervention in these patients.
Main Methods:
- Retrospective analysis of 28 patients with acute type A aortic dissection and total false lumen thrombosis.
- Initial conservative management with serial imaging; surgical repair when indicated.
- Calculation of false lumen to true lumen ratio (F/T) via CT scan.
Main Results:
- 15 patients (53.6%) ultimately required surgery.
- 1- and 5-year survival rates were high in both operative (93.3%, 80.0%) and non-operative (92.3%, 92.3%) groups.
- Mean F/T ratio was significantly lower in the operative group (30%) compared to the non-operative group (50%, p=0.04).
Conclusions:
- Conservative management with vigilant imaging follow-up is a reasonable strategy for selected thrombosed type A aortic dissections.
- A low initial F/T ratio and lack of aneurysm size reduction are key indicators for considering surgical repair.