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Outer Media Thickness at False Lumen and Secondary Aortic Dilatation After Acute Aortic Dissection

Takeshi Kinoshita1, Tohru Asai1, Tomoaki Suzuki2

  • 1Division of Cardiovascular Surgery, Shiga University of Medical Science, Otsu, Japan; Department of Cardiovascular Surgery, Juntendo University, Tokyo, Japan.

The Annals of Thoracic Surgery
|March 16, 2022
PubMed
Abstract

Insights

Outer media thickness (OMT) in patients with aortic dissection is linked to downstream aortic growth. Thinner OMT correlates with faster aortic dilation and increased risk of aortic events and mortality.

Area of Science:

  • Cardiovascular Surgery
  • Aortic Disease Research
  • Medical Imaging Analysis

Background:

  • Acute type A aortic dissection presents complex management challenges.
  • Understanding factors influencing secondary aortic dilatation is crucial for patient outcomes.
  • The role of outer media thickness (OMT) in false lumen dynamics requires further investigation.

Purpose of the Study:

  • To measure outer media thickness (OMT) in the false lumen of patients with DeBakey type I aortic dissection.
  • To assess the impact of OMT on the secondary dilatation of the downstream aorta.
  • To determine the association between OMT and aortic-related events and all-cause mortality.

Main Methods:

  • Microscopic analysis of intraoperatively collected aortic specimens to determine OMT.
  • Inclusion of 129 patients with DeBakey type I dissection, patent false lumen, and histopathologic examination.
  • Longitudinal follow-up using computed tomographic scans (average 5.1 scans/patient, median 4.3 years).

Main Results:

  • Significant variation in OMT was observed (median 0.21 mm, range 0.04-0.51 mm).
  • Aortic diameter growth rate showed an inverse correlation with OMT.
  • Lowest OMT tertile (<0.15 mm) demonstrated significantly faster aortic dilation and a 3.54-fold higher risk of aortic-related events.

Conclusions:

  • OMT is an independent predictor of aortic-related events and all-cause mortality in DeBakey type I aortic dissection.
  • Thinner outer media thickness (<0.15 mm) is associated with increased risk of aortic dilatation and adverse events.
  • OMT measurement offers valuable prognostic information for patients with aortic dissection.

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