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Effect of false lumen partial thrombosis on repaired acute type A aortic dissection
Meng-Ta Tsai1, Hsuan-Yin Wu2, Jun-Neng Roan3
1Division of Cardiovascular Surgery, Department of Surgery, National Cheng Kung University Hospital, Tainan, Taiwan.
The Journal of Thoracic and Cardiovascular Surgery
|March 25, 2014
Summary
Partial false lumen thrombosis after type A acute aortic dissection repair accelerates aortic growth and increases reoperation risk. However, it does not impact long-term survival rates.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Aortic Disease Research
Background:
- Conflicting results exist regarding the impact of partial false lumen thrombosis after type A acute aortic dissection (TAAAD) repair.
- Understanding the implications of residual false lumen status is crucial for patient management.
Purpose of the Study:
- To investigate the effects of a partially thrombosed false lumen on segmental aortic growth rates.
- To assess the impact on distal aortic reoperations and long-term survival following TAAAD repair.
Main Methods:
- Retrospective review of postoperative computed tomography scans from 67 patients.
- Independent definition of false lumen status (thrombosed, patent, partially thrombosed) in three segments of the descending thoracic aorta (DTA).
Main Results:
- Partial false lumen thrombosis correlated with significantly faster segmental aortic growth rates in all DTA segments (P<.001).
- Ten-year freedom from reoperation rates were notably lower in patients with partially thrombosed false lumens (62%) compared to completely thrombosed (100%) or patent (88%) lumens at the proximal DTA (P=.013).
- Overall 10-year survival rates were high (89%) and did not differ significantly across groups.
Conclusions:
- Partial thrombosis of a residual false lumen after TAAAD repair is associated with accelerated regional aortic expansion.
- This condition predicts an increased likelihood of requiring reoperation.
- Despite increased reoperation rates, partial false lumen thrombosis did not adversely affect overall long-term survival.
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