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 Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Takashi Ino Hideo Adachi Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kimura, N. Articles by Adachi, H. Search for Related Content PubMed Articles by Kimura, N. Articles by Adachi, H. Related Collections Great vessels

J Thorac Cardiovasc Surg 2008;136:1160-1166
© 2008 The American Association for Thoracic Surgery

Surgery for Acquired Cardiovascular Disease

Influence of patent false lumen on long-term outcome after surgery for acute type A aortic dissection

^a Department of Cardiovascular Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
^b Department of Cardiac Surgery, Kashiwa Hospital, Jikei University School of Medicine, Kashiwa, Japan

Received for publication October 27, 2007; revisions received February 10, 2008; accepted for publication May 20, 2008.

^_* Address for reprints: Naoyuki Kimura, MD, Department of Cardiovascular Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya, Saitama 330-0834, Japan. (Email: masashi{at}omiya.jichi.ac.jp).

Objective: The fate of the dissected distal aorta after surgery for acute type A aortic dissection has not been fully understood. We assessed the influence of a residual patent false lumen on long-term outcomes.

Methods: Two hundred eighteen patients underwent emergency surgery for DeBakey type I or IIIb retrograde acute type A aortic dissection (1997–2006). Aortic arch replacement was performed in selected patients whose entry site was in or extended into the aortic arch. In-hospital mortality was 7.3% (16/218), and 193 survivors (mean age 62 years) underwent enhanced computed tomography within 1 month after the operation. These patients were divided into two groups according to the status of the false lumen, whether patent (n = 124) or thrombosed (n = 69). In each group, segment-specific aortic growth rate, distal reoperation, and late survival were examined.

Results: Growth rate was determined in 139 (72.0%) patients who underwent serial computed tomography. Average growth rate in the patent group was greater than that in the thrombosed group (aortic arch [1.1 vs –0.41 mm per year; P = .005], proximal descending aorta [1.9 vs –0.71 mm per year; P <.001], and distal descending aorta [1.3 vs –0.70 mm per year; P = .002]). However, growth was slow (<1 mmper year) in about 50% of patients in the patent group. There was no significant difference in distal reoperation or late survival between the two groups.

Conclusions: The patent false lumen influences postoperative aortic enlargement. However, with careful follow-up, a favorable prognosis is expected even for patients with a residual patent false lumen.

This article has been cited by other articles:

				R. S. Bonser, A. M. Ranasinghe, M. Loubani, J. D. Evans, N. M. A. Thalji, J. E. Bachet, T. P. Carrel, M. Czerny, R. Di Bartolomeo, M. Grabenwoger, et al. Evidence, Lack of Evidence, Controversy, and Debate in the Provision and Performance of the Surgery of Acute Type A Aortic Dissection J. Am. Coll. Cardiol., December 6, 2011; 58(24): 2455 - 2474. [Abstract] [Full Text] [PDF]

				M. Glauber, M. Murzi, P. Farneti, S. Bevilacqua, M. Mariani, A. Tognarelli, T. Gasbarri, and S. Berti Aortic arch replacement with prophylactic aortic arch debranching during type A acute aortic dissection repair: initial experience with 23 patients Eur J Cardiothorac Surg, August 1, 2011; 40(2): 418 - 423. [Abstract] [Full Text] [PDF]

				F. Ius, C. Hagl, A. Haverich, and M. Pichlmaier Elephant trunk procedure 27 years after Borst: what remains and what is new? Eur J Cardiothorac Surg, July 1, 2011; 40(1): 1 - 12. [Abstract] [Full Text] [PDF]

				M. Murzi and M. Glauber Letter by Murzi and Glauber Regarding Article, "Extensive Primary Repair of the Thoracic Aorta in Acute Type A Aortic Dissection by Means of Ascending Aorta Replacement Combined With Open Placement of Triple-Branched Stent Graft: Early Results" Circulation, June 7, 2011; 123(22): e619 - e619. [Full Text] [PDF]

				P. Mastroroberto, M. Chello, G. Jannelli, and E. Covino Uncovered stent-graft in the treatment for residual patent false lumen after surgical repair for acute type A aortic dissection Interact CardioVasc Thorac Surg, February 1, 2011; 12(2): 202 - 204. [Abstract] [Full Text] [PDF]

				F. Ius, I. Vendramin, E. Mazzaro, G. Piccoli, F. Bassi, D. Gasparini, and U. Livi Transluminal Stenting in Type A Acute Aortic Dissection: Does the Djumbodis System Have Any Impact on False Lumen Evolution? Ann. Thorac. Surg., November 1, 2010; 90(5): 1450 - 1456. [Abstract] [Full Text] [PDF]

				M. Murzi, T. Gasbarri, and M. Glauber One-stage hybrid approach for type A acute aortic dissection repair: just because we can, should we do it? Interact CardioVasc Thorac Surg, November 1, 2010; 11(5): 598 - 598. [Full Text] [PDF]

				F. Albrecht, F. Eckstein, and P. Matt Is close radiographic and clinical control after repair of acute type A aortic dissection really necessary for improved long-term survival? Interact CardioVasc Thorac Surg, November 1, 2010; 11(5): 620 - 625. [Abstract] [Full Text] [PDF]

				M. Murzi and M. Glauber Should an Endovascular Procedure Be Combined With Resection for Type A Aortic Dissection? Ann. Thorac. Surg., October 1, 2009; 88(4): 1387 - 1388. [Full Text] [PDF]

				M. Glauber, M. Murzi, and A. Farneti Prophylactic aortic arch debranching during type A aortic dissection repair Eur J Cardiothorac Surg, May 1, 2009; 35(5): 921 - 922. [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 Interact CardioVasc Thorac Surg, April 1, 2009; 8(4): 431 - 434. [Abstract] [Full Text] [PDF]