Morphological prognostic factor of thoracoabdominal aortic dilation after acute type a dissection repair.

Abstract

Risk factors for late-term aortic dilation after acute type A aortic dissection repair have not been well examined. This study aimed to determine the relationship between the abdominal aortic true lumen location and thoraco-abdominal aortic dilation after the surgical repair for acute type A aortic dissection. Patients who were preoperatively diagnosed with acute type A aortic dissection between April 2014 and July 2022, were included in this study. We evaluated the renal artery-level dissected aortic morphology and classified the study population into two groups: ventral (those with true lumen located on the ventral side) and dorsal (other patients not designated in the ventral group) groups, based on the true lumen location. Aortic dilation was defined as thoraco-abdominal aortic expansion ≥5 mm on 1-year postoperative computed tomography image. We examined 49 surgical patients which were assigned to the ventral (n = 22) and dorsal (n = 27) groups. The number of patients with ≥5 mm thoraco-abdominal aortic dilation after surgery was significantly higher in the ventral group than in the dorsal group (90.9% vs 51.9%, P = 0.009). The multivariable logistic regression analysis showed that the ventral type was an independent prognostic factor of thoraco-abdominal aortic dilation after surgery (odds ratio, 6.01; 95% confidence interval, 1.56-23.77; P = 0.009). The true lumen location of the abdominal aorta in acute type A aortic dissection may be a prognostic factor of thoraco-abdominal aortic dilation after surgical repair.