Fate of aorta and clinical outcomes in patients with chronic type B aortic dissection: over 20-year experience

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E Sueyoshi1, H Nagayama, T Hayashida

  • 1Department of Radiology, Nagasaki University School of Medicine, Nagasaki, Japan - sueyo@nagasaki-u.ac.jp.

The Journal of Cardiovascular Surgery
|November 10, 2012
PubMed

Insights

Patients with type B aortic dissection (AD) face significant long-term risks. Over 44% experienced AD-related events, highlighting the need for proactive management in high-risk individuals.

Area of Science:

  • Cardiovascular Surgery
  • Vascular Medicine
  • Thoracic Surgery

Background:

  • The long-term prognosis and aortic remodeling in chronic type B aortic dissection (AD) remain incompletely understood.
  • Clarifying outcomes is crucial for guiding clinical management strategies.

Purpose of the Study:

  • To elucidate the fate of the aorta and very long-term clinical outcomes in patients with type B AD during the chronic phase.
  • To identify risk factors associated with adverse events in the chronic phase of type B AD.

Main Methods:

  • A retrospective review of 104 patients with type B AD who underwent regular follow-up CT scans (mean duration: 87.6 months).
  • Analysis of clinical data, including AD-related events (aneurysm, rupture, ischemia, re-dissection), AD-related deaths, and long-term survival.

Main Results:

  • Nearly half (44.2%) of patients experienced at least one AD-related event during follow-up.
  • Actuarial event-free rates at 1, 5, 10, and 20 years were 95±2%, 75±5%, 53±6%, and 13±7%, respectively.
  • Significant risk factors for AD-related events included initial aortic diameter ≥40 mm and false lumen blood flow.

Conclusions:

  • The aorta in type B chronic AD exhibits a high incidence of AD-related events over time.
  • Prophylactic surgical or endovascular interventions may be beneficial for high-risk patients to mitigate these events.
Abstract

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