Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Early and Mid-term Changes of the Distal Aorta after Total Arch Replacement for Acute Type A Aortic Dissection

  • Choi, Chang Hu (Department of Thoracic and Cardiovascular Surgery, Gachon University Gil Medical Center, Gachon University) ;
  • Park, Chul Hyun (Department of Thoracic and Cardiovascular Surgery, Gachon University Gil Medical Center, Gachon University) ;
  • Jeon, Yang Bin (Department of Thoracic and Cardiovascular Surgery, Gachon University Gil Medical Center, Gachon University) ;
  • Lee, So Young (Department of Thoracic and Cardiovascular Surgery, Gachon University Gil Medical Center, Gachon University) ;
  • Lee, Jae Ik (Department of Thoracic and Cardiovascular Surgery, Gachon University Gil Medical Center, Gachon University) ;
  • Park, Kook Yang (Department of Thoracic and Cardiovascular Surgery, Gachon University Gil Medical Center, Gachon University)
  • Received : 2012.06.29
  • Accepted : 2012.08.24
  • Published : 2013.02.05
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Abstract

Background: Total arch replacement (TAR) is being more widely performed due to recent advances in operative techniques and cerebral protective strategies. In this study, the authors reviewed the relationship between TAR and early- and mid-term changes of the false lumen after TAR in acute type A aortic dissection. Materials and Methods: Twenty-six patients (aged, $54.7{\pm}13.3$ years) who underwent TAR for acute type A dissection between June 2004 and February 2012 were reviewed. The relationship between the percentage change in the aortic diameter and the false lumen patency status was assessed by examining the early and late postoperative computed tomography imaging studies. Results: There were two in-hospital mortalities, one late death, and three follow-up loses. The mean follow-up duration for the final 21 patients studied was $54{\pm}19.0$ months (range, 20 to 82 months). The incidence of false lumen thrombosis within 2 weeks of surgery in the proximal, middle, and distal thoracic aorta, and the suprarenal and infrarenal abdominal aorta were 67%, 38%, 38%, 48%, and 33%, respectively, and 57%, 67%, 52%, 33%, and 33% for those examined at a mean of $49{\pm}18$ months after surgery, respectively. The false lumen regressed in 11 patients (42.3%). The aortic diameters were larger in the patients with a patent false lumen than those with a thrombosed false lumen at all levels of the descending aorta (p <0.05). Conclusion: TAR and a more complete primary tear-resection can be accomplished with a relatively low-risk of morbidity and mortality. Enlargement of the distal aorta significantly correlated with the false lumen patency status.

Keywords

References

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  1. Long-Term Changes in the Distal Aorta after Aortic Arch Replacement in Acute DeBakey Type I Aortic Dissection vol.49, pp.4, 2013, https://doi.org/10.5090/kjtcs.2016.49.4.264