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Effects of partial thrombosis on distal aorta after repair of acute DeBakey type I aortic dissection

Authors
 Suk-Won Song  ;  Byung-Chul Chang  ;  Bum-Koo Cho  ;  Gijong Yi  ;  Young-Nam Youn  ;  Sak Lee  ;  Kyung-Jong Yoo 
Citation
 JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, Vol.139(4) : 841-1, 2010 
Journal Title
 JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 
ISSN
 0022-5223 
Issue Date
2010
MeSH
Aneurysm, Dissecting/complications ; Aneurysm, Dissecting/surgery* ; Aorta/growth & development ; Aorta/physiopathology* ; Aortic Aneurysm/complications ; Aortic Aneurysm/surgery* ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Survival Analysis ; Thrombosis/etiology ; Thrombosis/mortality ; Thrombosis/physiopathology* ; Tomography, X-Ray Computed
Abstract
OBJECTIVE: Prognostic implications of partial thrombosis of the residual aorta after repair of acute DeBakey type I aortic dissection have not been elucidated. We sought to analyze the impact of partial thrombosis on segmental growth rates, distal aortic reprocedures, and long-term survival. METHODS: A total of 118 consecutive patients (55% were male; mean age, 60 years) with acute DeBakey type I aortic dissection underwent surgical repair (1997-2007). The hospital mortality rate was 17.8%. Survivors underwent serial computed tomography scans. Segment-specific average rates of enlargement were analyzed. Distal reprocedures and patient survival were examined. RESULTS: Sixty-six patients had imaging data sufficient for growth rate calculations. The median diameters within 2 weeks after repair were as follows: aortic arch, 3.5 cm; descending aorta, 3.6 cm; and abdominal aorta, 2.4 cm. Subsequent growth rates were artic arch, 0.34 mm/y, descending aorta, 0.51 mm/y, and abdominal aorta, 0.35 mm/y. Partial thrombosis of the residual aorta predicted greater growth in the distal aorta (P = .005). There were 13 distal aortic reprocedures (5 reoperations, 8 stent graft insertions) for 10 years, and reprocedure-free survival was 66%. Partial thrombosis (P = .002) predicted greater risk of aorta-related reprocedures. Cox analysis revealed that estimated glomerular filtration rate less than 60 mL/min/1.73 m(2) (P = .030), reintubation (P = .002), and partial thrombosis (P = .023) were independent predictors for poor survival. CONCLUSION: Partial thrombosis of the false lumen after repair of acute DeBakey type I aortic dissection, compared with complete patency or complete thrombosis, is a significant independent predictor of aortic enlargement, aorta-related reprocedures, and poor long-term survival
Full Text
http://www.sciencedirect.com/science/article/pii/S002252230901602X
DOI
10.1016/j.jtcvs.2009.12.007
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Song, Suk Won(송석원) ORCID logo https://orcid.org/0000-0002-9850-9707
Yoo, Kyung Jong(유경종) ORCID logo https://orcid.org/0000-0002-9858-140X
Youn, Young Nam(윤영남)
Yi, Gi Jong(이기종)
Lee, Sak(이삭) ORCID logo https://orcid.org/0000-0001-6130-2342
Chang, Byung Chul(장병철)
Cho, Bum Koo(조범구)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/100779
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