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Updated: Jan 12, 2026
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Author Spotlight: Using Point-of-Care Ultrasound for Comprehensive Evaluation of the Abdominal Aorta
Published on: September 8, 2023
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Influence of a Collapsed True Lumen in Acute Type A Aortic Dissection.
Kayo Sugiyama1, Yuki Orimoto2, Kazuma Kiryu3
1Department of Cardiac Surgery, Aichi Medical University Hospital, Nagakute, Aichi, Japan.
Summary
Patients with acute type A aortic dissection and a collapsed true lumen often experience malperfusion. Staged repair with thoracic endovascular aortic repair (TEVAR) can achieve aortic remodeling when standard methods fail.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Aortic Disease
Background:
- Acute type A aortic dissection (ATAAD) is a life-threatening condition.
- A collapsed true lumen in the descending aorta presents unique challenges in ATAAD management.
Purpose of the Study:
- To evaluate outcomes in ATAAD patients with a collapsed true lumen.
- To assess the effectiveness of surgical interventions for this specific patient group.
Main Methods:
- Retrospective analysis of 146 ATAAD patients undergoing surgery.
- Identification of 6 patients (4.1%) with a true lumen <10% of total area.
- Assessment of imaging, clinical characteristics, surgical techniques, and adverse events.
Main Results:
- Collapsed true lumen associated with preoperative spinal cord/peripheral malperfusion.
- Ascending aortic cannulation required in 2 cases due to inadequate true lumen perfusion.
- Successful one-year survival for all 6 patients; aortic remodeling achieved post-staged TEVAR.
Conclusions:
- Collapsed true lumen in ATAAD may lead to lower body malperfusion.
- Standard cardiopulmonary bypass may be insufficient.
- Staged repair with TEVAR is effective for aortic remodeling in complex ATAAD cases.
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