Document Detail


Risk factors for secondary dilatation of the aorta after acute type A aortic dissection.
MedLine Citation:
PMID:  15784368     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Prompt diagnosis of subsequent dilatation of the dissected aorta is crucial to reduce late mortality in these patients. This study focuses on risk factors for dilatation of the aorta after type A aortic dissection (AADA) affecting a normal-sized or slightly dilated aorta. METHODS: Overall 531 CT scans were analysed. Patients were included in the study if at least 3 CT scans were available after operative repair. 64 patients (59.8%) out of 107 patients full-field the inclusion criteria. Volumetric analyses of the aorta were performed. Patients were divided in 3 groups: group A included 26 patients (40.6%) without progression of the aortic diameter, group 2, 27 patients (42.2%) with slight progression and group 3, 11 patients (17.2%) with important progression, requiring surgery in 9 patients (81.8%). Risk-factors for progression of the aortic size were analysed and compared between the groups. RESULTS: Patients from group 3 were younger 57.7+/-13.4 vs. 61.9+/-11.6 in group 1 (P<0.05) and were more frequent female (45.4 vs. 23.1%; P<0.05). Dissection of the supraaortic branches (100 vs. 80.8%; P<0.05), the presence of preoperative cerebral, visceral or peripheral malperfusion (54.6 vs. 26.9%; P<0.05) and contrast enhancement in the false lumen during the follow-up (72.7 vs. 57.7%; P=0.07) were additional risk factors for late aortic dilatation in these patients. CONCLUSIONS: Acute type A aortic dissection in younger patients, involving the supraaortic branches and/or combined with malperfusion syndrome favour secondary dilatation. A close follow-up is mandatory to prevent acute complications of the diseased downstream aorta following repair of a AADA.
Authors:
Franz F Immer; Urs Hagen; Pascal A Berdat; Friedrich S Eckstein; Thierry P Carrel
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Publication Detail:
Type:  Journal Article     Date:  2004-12-30
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  27     ISSN:  1010-7940     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  2005 Apr 
Date Detail:
Created Date:  2005-03-23     Completed Date:  2005-06-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  654-7     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Surgery, University Hospital, 3010 Berne, Switzerland. franzimmer@yahoo.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Aged
Aneurysm, Dissecting / surgery*
Aorta / pathology*
Aortic Aneurysm, Thoracic / surgery*
Dilatation, Pathologic / etiology,  radiography
Disease Progression
Female
Follow-Up Studies
Humans
Male
Middle Aged
Patient Selection
Postoperative Complications*
Reoperation
Risk Factors
Tomography, X-Ray Computed

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


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