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Locational Impact of Luminal Communication on Aortic Diameter Changes and Reintervention in Acute Type I Aortic Dissection

Authors
 Woon Heo  ;  Suk-Won Song  ;  Shin-Young Lee  ;  Tae-Hoon Kim  ;  Jin-Seong Lee  ;  Kyung-Jong Yoo  ;  Bum-Koo Cho 
Citation
 EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, Vol.55(6) : 1037-1044, 2019-06 
Journal Title
 EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY 
ISSN
 1010-7940 
Issue Date
2019-06
Keywords
Acute type I aortic dissection ; Aortic diameter ; Imaging
Abstract
Objectives: The aim of this study is to evaluate the locational impact of a luminal communication on aortic diameter changes and reintervention after surgical repair of acute type I aortic dissection. Methods: Between 2009 and 2017, 304 patients underwent operation for acute type I aortic dissection. Among them, 93 patients were enrolled. The luminal communications were analysed in segment 1 (the proximal descending thoracic aorta), segment 2 (the distal descending thoracic aorta) and segment 3 (the abdominal aorta). The aortic diameter was measured at the pulmonary artery bifurcation, coeliac axis, maximal abdominal aorta and maximal thoraco-abdominal aorta using serial follow-up computed tomography scans. The linear mixed model was used, and the rate of freedom from reintervention was analysed. Results: In the adjusted analysis, the initial diameter of the maximal abdominal aorta and the first luminal communication in segment 1 was statistically significant. However, the slope value of the maximal abdominal aorta was smaller than that of the first luminal communication in segment 1 (0.024 vs 0.198). The 3-year freedom from reintervention rate was significantly higher in patients without a luminal communication than in those with an initial luminal communication in segment 1 (96% vs 47%, log rank, P = 0.003). Conclusions: A luminal communication at the proximal descending thoracic aorta (segment 1) is a significant factor for an increasing aortic diameter and reintervention after surgical repair of acute type I aortic dissection.
Full Text
https://academic.oup.com/ejcts/article/55/6/1037/5272477
DOI
10.1093/ejcts/ezy427
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Tae Hoon(김태훈) ORCID logo https://orcid.org/0000-0003-3987-0057
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, Shin Young(이신영)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/175825
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