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Early aortic growth in acute descending aortic dissection
Mikolaj Berezowski1,2, Johannes Scheumann1, Friedhelm Beyersdorf1
1Department of Cardiovascular Surgery, Faculty of Medicine, Heart Centre Freiburg University, University of Freiburg, Freiburg, Germany.
Interactive Cardiovascular and Thoracic Surgery
|January 19, 2022
Summary
Acute aortic dissection causes rapid aortic diameter growth, particularly in the first 3 days. Entry location significantly influences this increase in descending aortic dissection patients.
Area of Science:
- Cardiovascular Medicine
- Radiology
- Medical Imaging
Background:
- Acute aortic dissection destabilizes the aortic wall, leading to increased diameter.
- The precise changes in aortic diameter during acute and subacute phases are not fully understood.
Purpose of the Study:
- To evaluate changes in aortic geometry within 30 days of descending aortic dissection onset.
- To investigate the rate and influencing factors of aortic diameter increase post-dissection.
Main Methods:
- Retrospective analysis of 42 patients with acute type B and non-A non-B dissection.
- Utilized at least two computed tomography angiography scans within 30 days post-dissection.
- Exclusion criteria included thrombosed false lumen, connective tissue disorders, and prior aortic repair.
Main Results:
- The highest aortic diameter growth rate was observed in the first quartile of the thoracic aorta.
- Growth rates were 0.66 mm/day (0-3 days), 0.29 mm/day (4-7 days), and 0.06 mm/day (8-30 days).
- Proximal entry location and arch concavity entry were associated with greater aortic diameter increase.
Conclusions:
- Significant aortic diameter growth occurs within the first week post-dissection, peaking in the initial 3 days.
- The location of the dissection entry is a key factor associated with early aortic enlargement.
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