Document Detail


Long-term results after repair of type a acute aortic dissection according to false lumen patency.
MedLine Citation:
PMID:  19766814     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Late survival and freedom from retreatment on the descending aorta was evaluated after ascending aortic repair for type A acute aortic dissection (TAAAD). METHODS: Between March 1992 and January 2006, 189 TAAAD patients (mean age, 52 +/- 11; range, 17 to 83 years) were included; of these, 58 had a patent false lumen, and 49 had Marfan syndrome. The descending aorta was evaluated postoperatively with computed tomography (CT). Late outcomes were assessed by Cox regression analysis and actuarial survival and freedom from retreatment by the Kaplan-Meier method. Mean follow-up was 88 +/- 44 months. RESULTS: There were 38 (20%) late deaths. At 10 years, survival was 89.8% +/- 2.1% for patients with an occluded false lumen and 59.8% +/- 3.5% for patients with a patent false lumen (p = 0.001), and freedom from retreatment on the descending aorta was 94.2% +/- 3.1% for an occluded false lumen and 63.7% +/- 2.6% for a patent false lumen (p < 0.0001). Descending aortic rupture (p = 0.002) and a patent false lumen (p = 0.001) were predictors for late death. Patent false lumen (p = 0.0001), Marfan syndrome (p = 0.03), and descending aortic diameter 4.5 cm or larger (p = 0.002) were predictors for retreatment. CONCLUSIONS: A patent false lumen was a predictor for late death and retreatment on the descending aorta. Marfan syndrome and aortic size exceeding 4.5 cm were predictors for late retreatment. These patients require very close follow-up and a plan for retreatment on the descending aorta to prevent sudden rupture and late death.
Authors:
Khalil Fattouch; Roberta Sampognaro; Emiliano Navarra; Marco Caruso; Calogera Pisano; Giuseppe Coppola; Giuseppe Speziale; Giovanni Ruvolo
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  88     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-09-21     Completed Date:  2009-10-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1244-50     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiac Surgery, University of Palermo, Palermo, Italy. khalilfattouch@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adolescent
Aged
Aged, 80 and over
Aneurysm, Dissecting / diagnosis,  mortality,  surgery*
Aortic Aneurysm, Thoracic / diagnosis,  mortality,  surgery*
Blood Vessel Prosthesis Implantation / methods*
Female
Follow-Up Studies
Hospital Mortality / trends
Humans
Italy / epidemiology
Male
Middle Aged
Retrospective Studies
Survival Rate / trends
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Young Adult
Comments/Corrections
Comment In:
Ann Thorac Surg. 2009 Oct;88(4):1250   [PMID:  19766815 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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