HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Friedrich S. Eckstein Thierry P. Carrel Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Immer, F. F. Articles by Carrel, T. P. Search for Related Content PubMed PubMed Citation Articles by Immer, F. F. Articles by Carrel, T. P. Related Collections Great vessels

Eur J Cardiothorac Surg 2005;27:654-657
© 2005 Elsevier Science NL

Risk factors for secondary dilatation of the aorta after acute type A aortic dissection

Department of Cardiovascular Surgery, University Hospital, 3010 Berne, Switzerland

Received 9 September 2004; received in revised form 24 November 2004; accepted 29 November 2004.

^* Corresponding author. Tel.: +41 31 632 23 76; fax: +41 31 632 44 43. (E-mail: franzimmer{at}yahoo.de).

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.

Key Words: Aortic dissection • Follow-up • Risk-factors • Reoperation • Dilatation

This article has been cited by other articles:

				K. Fattouch, R. Sampognaro, E. Navarra, M. Caruso, C. Pisano, G. Coppola, G. Speziale, and G. Ruvolo Long-term results after repair of type a acute aortic dissection according to false lumen patency. Ann. Thorac. Surg., October 1, 2009; 88(4): 1244 - 1250. [Abstract] [Full Text] [PDF]

				H. Tanaka, K. Okada, Y. Kawanishi, M. Matsumori, and Y. Okita Clinical significance of anastomotic leak in ascending aortic replacement for acute aortic dissection Interactive CardioVascular and Thoracic Surgery, August 1, 2009; 9(2): 209 - 212. [Abstract] [Full Text] [PDF]

				N. Kimura, M. Tanaka, K. Kawahito, A. Yamaguchi, T. Ino, and H. Adachi Early postoperative aortic rupture following surgery for acute type A aortic dissection Interactive CardioVascular and Thoracic Surgery, April 1, 2009; 8(4): 431 - 434. [Abstract] [Full Text] [PDF]

				N. Kimura, M. Tanaka, K. Kawahito, A. Yamaguchi, T. Ino, and H. Adachi Influence of patent false lumen on long-term outcome after surgery for acute type A aortic dissection. J. Thorac. Cardiovasc. Surg., November 1, 2008; 136(5): 1160 - 1166.e3. [Abstract] [Full Text] [PDF]

				A. Zierer, R. K. Voeller, K. E. Hill, N. T. Kouchoukos, R. J. Damiano Jr, and M. R. Moon Aortic Enlargement and Late Reoperation After Repair of Acute Type A Aortic Dissection Ann. Thorac. Surg., August 1, 2007; 84(2): 479 - 487. [Abstract] [Full Text] [PDF]

				C. Olsson, N. Eriksson, E. Stahle, and S. Thelin Surgical and long-term mortality in 2634 consecutive patients operated on the proximal thoracic aorta Eur. J. Cardiothorac. Surg., June 1, 2007; 31(6): 963 - 969. [Abstract] [Full Text] [PDF]

				F F Immer Is there a place for D-dimers in acute type A aortic dissection? Heart, June 1, 2006; 92(6): 727 - 728. [Abstract] [Full Text] [PDF]

				F. F. Immer, V. Grobety, A. Lauten, and T. P. Carrel Does malperfusion syndrome affect early and mid-term outcome in patients suffering from acute type A aortic dissection? Interactive CardioVascular and Thoracic Surgery, April 1, 2006; 5(2): 187 - 190. [Abstract] [Full Text] [PDF]

				K. Tanaka, K. Morioka, W. Li, N. Yamada, A. Takamori, M. Handa, S. Tanabe, and A. Ihaya Adventitial inversion technique without the aid of biologic glue or Teflon buttress for acute type A aortic dissection Eur. J. Cardiothorac. Surg., December 1, 2005; 28(6): 864 - 869. [Abstract] [Full Text] [PDF]

				F. F. Immer, E. Krahenbuhl, U. Hagen, M. Stalder, P. A. Berdat, F. S. Eckstein, J. Schmidli, and T. P. Carrel Large Area of the False Lumen Favors Secondary Dilatation of the Aorta After Acute Type A Aortic Dissection Circulation, August 30, 2005; 112(9_suppl): I-249 - I-252. [Abstract] [Full Text] [PDF]