Document Detail

Impact of aortic dimensions and pulse pressure on late aneurysm formation in operated type A aortic dissection. A magnetic resonance imaging study.
MedLine Citation:
PMID:  18246444     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Patients operated on for type A aortic dissection remain at risk of long-term aneurysm development, the main cause for late death. The aim of this study was to identify early predictors for aneurysm formation at three-years after surgery. METHODS: A study group of 70 consecutive patients (52 +/- 10 years-old, 41 male), operated on for aortic dissection with replacement of the ascending segment, was evaluated prospectively for three-years. In order to detect aneurysm formation, the dimension of residual distal aortic segments was obtained soon after surgery and then annually for three years using cardiovascular magnetic resonance. RESULTS: During follow-up (38 +/- 2.6 months), aneurysm was found in 25 patients (35%) involving residual segments. Larger initial dimension of segments, higher pulse pressure, lower distensibility of residual segments and the presence of a residual flap were univariately associated with aneurysm. Multivariate analysis identified the initial dimension (mm) of the descending thoracic aorta (OR 1.47, 95%CI: [1.19-1.82]) and pulse pressure (OR 1.43,95%CI: [1.10-1.86]) as independent variables for aneurysm formation. A risk score using pulse pressure and descending thoracic dimension was constructed. Patients with <or=24 points had no late aneurysm formation, while those with a score >or=45 yielded 100% of aneurysm frequency. CONCLUSIONS: Type A aortic dissection treated by graft interposition is associated with a high risk of aneurysm formation. Early post-operative pulse pressure and the descending thoracic aortic dimension were independent variables and seem to be the main predictors for the outcome.
Ana G Almeida; Angelo L Nobre; Ricardo A Pereira; Altamiro Costa-Pereira; Clara Tavares; João Cravino; Mário G Lopes
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-02-02
Journal Detail:
Title:  The international journal of cardiovascular imaging     Volume:  24     ISSN:  1569-5794     ISO Abbreviation:  Int J Cardiovasc Imaging     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-07-08     Completed Date:  2008-12-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100969716     Medline TA:  Int J Cardiovasc Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  633-40     Citation Subset:  IM    
Cardiology and Cardiothoracic Surgery Service, University Hospital Santa Maria, Faculty of Medicine, Lisbon University, Lisbon, Portugal.
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MeSH Terms
Aneurysm, Dissecting / pathology*,  physiopathology,  surgery
Aorta, Thoracic / pathology*,  physiopathology,  surgery
Aortic Aneurysm, Thoracic / pathology*,  physiopathology,  surgery
Aortography / methods*
Blood Pressure*
Blood Vessel Prosthesis Implantation*
Magnetic Resonance Angiography*
Middle Aged
Odds Ratio
Prospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Comment In:
Int J Cardiovasc Imaging. 2008 Aug;24(6):641-3   [PMID:  18415703 ]

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