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Aortic expansion after acute type B aortic dissection

Frederik H W Jonker1, Santi Trimarchi, Vincenzo Rampoldi

  • 1Department of Surgery, Maasstad Hospital, Rotterdam, the Netherlands. jonkerf@maasstadziekenhuis.nl

The Annals of Thoracic Surgery
|July 11, 2012
PubMed

Insights

White race and smaller initial aortic diameter predict aortic expansion in acute type B aortic dissection (ABAD) patients. Female sex, intramural hematoma, and calcium-channel blockers may decrease expansion.

Area of Science:

  • Cardiovascular Medicine
  • Vascular Surgery
  • Medical Research

Background:

  • Acute type B aortic dissection (ABAD) patients medically managed can experience aortic enlargement, increasing risks of aneurysm and rupture.
  • Identifying predictors of aortic expansion is crucial for managing ABAD patients.

Purpose of the Study:

  • To investigate predictors of aortic expansion in patients with acute type B aortic dissection (ABAD).

Main Methods:

  • Analysis of 191 ABAD patients from the International Registry of Acute Aortic Dissection (1996-2010).
  • Medical therapy alone was administered; descending aortic diameter was measured at admission and follow-up.
  • Multivariate regression analysis assessed factors influencing the annual aortic expansion rate.

Main Results:

  • Aortic expansion occurred in 59% of patients, with a mean rate of 1.7±7 mm/y.
  • White race and initial aortic diameter <4.0 cm were linked to increased expansion.
  • Female sex, intramural hematoma, and calcium-channel blocker use were associated with decreased expansion.

Conclusions:

  • White race and smaller initial aortic diameter are predictors of increased aortic expansion in ABAD.
  • Female sex, intramural hematoma, and calcium-channel blockers may reduce aortic expansion rates.
  • Further research into calcium-channel blockers for ABAD management is warranted.
Abstract

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