| Risk factors for secondary dilatation of the aorta after acute type A aortic dissection. | |
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MedLine Citation:
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PMID: 15784368 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Franz F Immer; Urs Hagen; Pascal A Berdat; Friedrich S Eckstein; Thierry P Carrel |
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Publication Detail:
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Type: Journal Article Date: 2004-12-30 |
Journal Detail:
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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:
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Created Date: 2005-03-23 Completed Date: 2005-06-30 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8804069 Medline TA: Eur J Cardiothorac Surg Country: England |
Other Details:
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Languages: eng Pagination: 654-7 Citation Subset: IM |
Affiliation:
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Department of Cardiovascular Surgery, University Hospital, 3010 Berne, Switzerland. franzimmer@yahoo.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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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