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Surgery for acute Type I aortic dissection without resection of supra-aortic entry sites leads to unfavourable aortic remodelling

Authors
 Woon Heo  ;  Suk-Won Song  ;  Kwang-Hun Lee  ;  Shin-Young Lee  ;  Tae-Hoon Kim  ;  Min-Young Baek  ;  Kyung-Jong Yoo 
Citation
 European Journal of Cardio-Thoracic Surgery, Vol.54(1) : 34-41, 2018 
Journal Title
 European Journal of Cardio-Thoracic Surgery 
ISSN
 1010-7940 
Issue Date
2018
Abstract
OBJECTIVES: This study aimed to evaluate the impact of remnant re-entries in arch branches on postoperative change in the aortic arch and descending aortic diameters and the rate of major adverse aortic events. METHODS: Between January 2010 and December 2016, 249 patients underwent surgery for acute Type I aortic dissection. Patients who underwent total arch replacement, had Marfan syndrome or had intramural haematoma were excluded. Seventy-two patients with predischarge and follow-up computed tomography scans were enrolled. Patients with and without re-entries in the arch branches after surgery were assigned to the supra-aortic entry (SAE, n = 21) and no supra-aortic entry (n = 51) groups, respectively. Diameters were measured at 7 levels: the innominate artery, left common carotid artery, left subclavian artery, 20 mm distal to the left subclavian artery, pulmonary artery bifurcation, coeliac axis and maximal diameter of the descending thoracic aorta. RESULTS: Growth rates at the levels of the pulmonary artery bifurcation and 20 mm distal to the left subclavian artery were significantly higher in the SAE group than in the no supra-aortic entry group. The rate of freedom from major adverse aortic events (annual growth >5 mm or maximal diameter of the descending thoracic aorta >50 mm) at 5 years was significantly higher in the no supra-aortic entry group than in the SAE group. CONCLUSIONS: Remnant SAE leads to unfavourable aortic remodelling after acute Type I aortic dissection repair.
Full Text
https://academic.oup.com/ejcts/article/54/1/34/4828178
DOI
10.1093/ejcts/ezx504
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Tae-Hoon(김태훈) ORCID logo https://orcid.org/0000-0003-4200-3456
Baek, Min Young(백민영)
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
Lee, Kwang Hun(이광훈)
Lee, Shin Young(이신영)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/162034
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