Morphologic prognostic factor for thoracoabdominal aortic dilation after acute type A dissection repair.

Area of Science:

• Cardiovascular Surgery
• Aortic Diseases
• Medical Imaging

Background:

• Late-term aortic dilation after acute type A aortic dissection (aTAAD) repair requires further investigation.
• Understanding risk factors is crucial for improving patient outcomes.

Purpose of the Study:

• To investigate the relationship between abdominal aortic true lumen location and thoraco-abdominal aortic dilation post-aTAAD repair.
• To identify prognostic factors for aortic dilation after aTAAD surgery.

Main Methods:

• Retrospective analysis of 49 patients with aTAAD undergoing surgical repair (April 2014 - July 2022).
• Classification into 'ventral' (true lumen on ventral side) and 'dorsal' groups based on renal artery-level morphology.
• Definition of thoraco-abdominal aortic dilation as ≥5 mm expansion on 1-year postoperative CT scans.

Main Results:

• The ventral group (n=22) showed significantly higher rates of thoraco-abdominal aortic dilation (90.9%) compared to the dorsal group (n=27, 51.9%; P=0.009).
• Ventral true lumen location was identified as an independent prognostic factor for post-operative thoraco-abdominal aortic dilation (OR, 6.01; P=0.009).

Conclusions:

• Abdominal aortic true lumen location, specifically the ventral type, may serve as a prognostic indicator for thoraco-abdominal aortic dilation after aTAAD surgical repair.
• This finding aids in risk stratification and personalized follow-up strategies for aTAAD patients.