How does descending aorta geometry change when it dissects?

Rylski, Bartosz; Muñoz, Camila; Beyersdorf, Friedhelm; Siepe, Matthias; Reser, Diana; Carrel, Thierry; Schönhoff, Florian; Schlensak, Christian; Lescan, Mario; Eckstein, Hans-Henning; Reutersberg, Benedikt; Erbel, Raimund; Janosi, Rolf Alexander; Czerny, Martin (2018). How does descending aorta geometry change when it dissects? European journal of cardio-thoracic surgery, 53(4), pp. 815-821. Oxford University Press 10.1093/ejcts/ezx292

Preview

Text ezx292.pdf - Published Version Available under License Publisher holds Copyright. Download (566kB) | Preview

OBJECTIVES

Thoracic endovascular aortic repair is the treatment of choice in complicated acute type B aortic dissection. How to infer predissection aortic diameter is not well understood. Our aim was to delineate changes in descending aortic geometry due to dissection.

METHODS

Five tertiary centres reviewed their acute aortic dissection type B databases containing 802 patients. All patients who had undergone computed tomography angiography less than 2 years before and immediately after aortic dissection onset were included. We compared the aortic geometry before and after the dissection onset.

RESULTS

Altogether 25 patients were included [median age 60 (first quartile 52, third quartile 72) years; 60% men]. In all except 1 patient, the maximum descending aortic diameter was less than 45 mm before aortic dissection onset. The largest increase in diameter induced by the dissection was observed in the proximal descending aorta 28.2 (25.1, 32.1) vs 34.6 (31.3, 39.1) mm (+6.4 mm; +23%; P  <   0.001). The thoracic descending aortic length increased after the dissection onset [253.3 (229.3, 271.9) vs 261.3 (247.9, 285.4) mm; P  =   0.003]. The predissection aortic diameter of the proximal thoracic descending aorta was 7.9 (5.2, 10.7) mm larger ( P  <   0.001) than the post-dissection area-derived true-lumen diameter and 2.5 (1.3, 6.1) mm larger than the maximum true-lumen diameter ( P  <   0.001).

CONCLUSIONS

Type B aortic dissection increases the diameter, length and volume of the descending thoracic aorta. The predissection aortic diameter most closely resembles the post-dissection maximum diameter of the true lumen.

Interest & Impact

Downloads

156 since deposited on 29 Nov 2017
37 in the past 12 months

Citations

5 Citations in Web of Science ®
6 Citations in Scopus

Search

in Google Scholar™

Services

Actions (login required)

Edit item

Actions (login required)

Edit item