Abstract
Objectives: According to the International Registry of Acute Aortic Dissection, >70% of patients with type-B aortic dissection (AD) have delayed aortic growth. The objective of this study was to investigate the morphologic characteristics of aortic enlargement in type-B AD. Methods: A total of 120 patients with uncomplicated acute type-B aortic dissection (uATBAD) were divided into 4 groups according to the presence of a patent or thrombosed false lumen (FL) with or without aortic enlargement. In all groups, the area of the true lumen (TL) and the FL were measured on axial computed tomography images. Results: A total of 120 uATBAD patients were evaluated: patent FL with (PE, N = 28, 23%) or without aortic enlargement (PU, N = 17, 14%) and thrombosed FL with (TE, N = 34, 28%) or without enlargement (TU, N = 41, 34%). The initial aortic diameter was not significantly different among the 4 groups (PE vs. PU = 39 ± 8 vs. 37 ± 10 (p = 0.354); TE vs. TU = 38 ± 6 vs. 37 ± 6 (p = 0.391)). The area of the FL tended to be larger in the PE group. In contrast, the area of the TL was significantly larger in the TE group. Late outcomes of uATBAD treated with optimal medical treatment were acceptable. Conclusions: In patients with uATBAD and a thrombosed FL, the patients with aortic enlargement tended to be increased TL size. In contrast, in patients with a patent FL, the patients with aortic enlargement tended to be increased FL size.
Highlights
Acute aortic dissection is medical and/or surgical emergency
A total of 120 patients with uncomplicated acute type-B aortic dissection were divided into 4 groups according to the presence of a patent or thrombosed false lumen (FL) with or without aortic enlargement
Over the 12-year study period from 2004 to 2017, 120 patients presented with uncomplicated acute type B aortic dissection
Summary
Acute aortic dissection is medical and/or surgical emergency. Complicated type B aortic dissection having impending rupture, organ ischemia, propagation of the dissection, or continued pain should be treated by surgical repair at acute phase. Patients presenting with uncomplicated acute type-B aortic dissection (uATBAD) are typically treated conservatively. The long-term prognosis of these patients is far less favorable, including enlargement of the aorta in 73.3% of patients treated with medical therapy [3], and mortality rates ranging from 21% to 36% after 5 years [4] [5] [6]
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.