Extent of Acute Type A Aortic Dissection in Patients With Organ Cysts

We investigated whether the extent of degeneration of the ascending aortic wall found in patients with acute type A aortic dissection is associated with the presence of organ cysts.

In total, 120 consecutive patients diagnosed for acute type A aortic dissection using computer tomography at Tampere University Hospital were evaluated, screened for organ cysts, and followed for a mean 6.7-years (SDs 4.6) after surgery. The ascending aortic wall resected in surgery in patients with and without cysts was analysed for 11 different histopathological variables expressed as point score units (PSU). Multivariable binary logistic regression analysis adjusted for age and sex was performed to investigate the association of the presence of elastic fibre thinning with the presence of cysts.

Out of 120 patients, there were 45 patients with at least 1 cyst including ovarian, renal, liver or epididymis cysts, and 75 with none. The mean age was 65.6 years (SD 11.8). Increased extent of elastic fibre thinning and the presence of thickening of the medial layer of the vasa vasorum were often present in patients with cysts as compared with those without (2.0 [1.0-2.0] vs 1.0 [0-2.0], PSU, P = .020 and 26.7% vs 12.0%, P = .049, respectively). According to the adjusted multivariable binary logistic regression analysis, the presence of elastic fibre thinning was associated with cysts (adjusted odds ratio: 2.636, 95% CI, 1.143-9.095, P = .023).

The presence of cysts in patients requiring surgery for acute type A aortic dissection may reflect the extent of aortic wall tissue degeneration.