Research article summary (published 29 Sep 2009):

Long-term results after repair of type a acute aortic dissection according to false lumen patency.

Full Abstract

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.

Author information

Author/s: Fattouch, Khalil (K); Sampognaro, Roberta (R); Navarra, Emiliano (E); Caruso, Marco (M); Pisano, Calogera (C); Coppola, Giuseppe (G); Speziale, Giuseppe (G); Ruvolo, Giovanni (G);

Affiliation: Department of Cardiac Surgery, University of Palermo, Palermo, Italy. khalilfattouch(-atsign-)hotmail.com

Journal and publication information

Publication Type: Comparative Study; Journal Article; Multicenter Study

Journal: The Annals of thoracic surgery (Ann Thorac Surg), published in Netherlands. (Language: eng)

Reference: 2009-Oct; vol 88 (issue 4) : pp 1244-50

Dates: Created 2009/09/21; Completed 2009/10/08;

PMID: 19766814, status: MEDLINE (last retrieved date: 10/8/2009)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

CommentIn: Ann Thorac Surg. 2009 Oct;88(4):1250. (PMID: 19766815)

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MeSH headings (categories)

This article was linked to the MeSH Headings (categories) shown below.

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

Note: Bold headings indicate primary MeSH headings or qualifiers.

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