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

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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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiovascular Surgery

UniBE Contributor:

Carrel, Thierry; Schönhoff, Florian and Czerny, Martin

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1010-7940

Publisher:

Oxford University Press

Language:

English

Submitter:

Daniela Huber

Date Deposited:

29 Nov 2017 07:56

Last Modified:

25 Apr 2018 11:36

Publisher DOI:

10.1093/ejcts/ezx292

PubMed ID:

28958027

Uncontrolled Keywords:

Aorta Aortic dissection Aortic surgery Thoracic endovascular aortic repair

BORIS DOI:

10.7892/boris.106733

URI:

https://boris.unibe.ch/id/eprint/106733

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