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Impact of false lumen volume on admission coagulopathy in acute type A aortic dissection

Georges Abi Abdallah1, Marie Potier2, Elodie Lang2

  • 1Department of Anaesthesiology and Critical Care, AP-HP, European Georges-Pompidou Hospital, Paris, France; Université Paris Cité, Inserm, PARCC, UMR_S970, Paris, France.

Anaesthesia, Critical Care & Pain Medicine
|March 24, 2026
PubMed

Insights

The size of the false lumen in acute type A aortic dissection (ATAAD) independently predicts preoperative coagulopathy. Larger false lumen volumes correlate with bleeding disorders and impact patient outcomes.

Area of Science:

  • Cardiovascular Surgery
  • Hematology
  • Radiology

Background:

  • Preoperative coagulopathy is common in acute type A aortic dissection (ATAAD) and affects patient outcomes.
  • The relationship between the anatomical burden of the false lumen and early coagulopathy in ATAAD is not well understood.

Purpose of the Study:

  • To investigate whether the indexed false lumen volume in ATAAD independently predicts preoperative coagulopathy.
  • To assess the correlation between false lumen volume and coagulation parameters.

Main Methods:

  • Retrospective analysis of 55 ATAAD patients undergoing urgent surgery (2019-2023).
  • Coagulation assessment via preoperative blood samples; coagulopathy defined as prothrombin time ratio (PTr) > 1.2.
  • Three-dimensional volumetric analysis of the dissected aorta using CT angiography to determine indexed false lumen volume.

Main Results:

  • 16 patients (29%) presented with coagulopathy, showing reduced coagulation factors and increased D-dimer levels.
  • Patients with coagulopathy had significantly greater indexed false lumen volume (162 mL/m² vs. 112 mL/m²).
  • Indexed false lumen volume was an independent predictor of coagulopathy (OR 1.38) and correlated with hemostatic disorders.

Conclusions:

  • Indexed false lumen volume is an independent predictor of preoperative coagulopathy in ATAAD.
  • Three-dimensional volumetric assessment offers a more relevant anatomical correlate of coagulopathy than traditional 2D indices.
  • Findings may inform perioperative strategies for ATAAD patients.
Abstract

Keywords:
Acute type A aortic dissectionBleedingCoagulopathyComputed tomography

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