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Risk factors for proximal and distal aortic events after type A acute aortic dissection.
Akita, Sho; Tokuda, Yoshiyuki; Kato, Wataru; Tanaka, Keisuke; Mutsuga, Masato.
Afiliación
  • Akita S; Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Syowa-ku, Nagoya City, Aichi, 466-8560, Japan. sakita0776@hotmail.co.jp.
  • Tokuda Y; Department of Cardiovascular Surgery, Nagoya Daini Redcross Hospital, 2-9, Myoken-cho, Showa-ku, Nagoya, Aichi, 466-8650, Japan. sakita0776@hotmail.co.jp.
  • Kato W; Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Syowa-ku, Nagoya City, Aichi, 466-8560, Japan.
  • Tanaka K; Department of Cardiovascular Surgery, Nagoya Daini Redcross Hospital, 2-9, Myoken-cho, Showa-ku, Nagoya, Aichi, 466-8650, Japan.
  • Mutsuga M; Department of Cardiovascular Surgery, Nagoya Daini Redcross Hospital, 2-9, Myoken-cho, Showa-ku, Nagoya, Aichi, 466-8650, Japan.
Gen Thorac Cardiovasc Surg ; 2024 Sep 17.
Article en En | MEDLINE | ID: mdl-39287769
ABSTRACT

OBJECTIVES:

Type A acute aortic dissection (TAAAD) is a life-threatening condition often requiring emergency surgery, with approximately 30% of patients needing reoperation. This study aimed to identify predictors of long-term aortic events from early postoperative computed tomography (CT) examinations.

METHODS:

A total of 336 cases underwent TAAAD surgery at two institutions between 2002 and 2018. Of these, 302 patients received CT examinations immediately after initial TAAAD surgery. Predictors of aortic events were evaluated from these early postoperative CT exams. Aortic events were defined as any events involving aortic-related death, open surgery, reoperation, endovascular stenting, or thoracic aorta diameter enlargement to ≥ 55 mm.

RESULTS:

Excluding 34 in-hospital deaths (10.1%; 34/336), the 1-, 5-, and 10-year actuarial survival rates after primary TAAAD surgery were 98.2%, 88.6%, and 81.7%, respectively. Over a mean follow-up period of 7.4 ± 5.1 years, 67 aortic events (proximal 19, distal 45, both 3) were observed. Freedom from proximal aortic events was 98.6%, 93.9%, and 85.2% at 1, 5, and 10 years, respectively. Proximal anastomosis new entry was identified as a significant risk factor for aortic events, with a 92% vs. 42% incidence at 10 years (p < 0.001). Freedom from distal aortic events was 99.6%, 84.5%, and 67.2% at 1, 5, and 10 years, respectively. A false/true area ratio greater than 1 and distal anastomosis new entry were significant risk factors for aortic events (low-risk group 83.3% vs. high-risk group 42.3% at 10 years, p < 0.001).

CONCLUSIONS:

Detailed analysis of early postoperative CT scans following primary TAAAD surgery may help identify predictors of subsequent aortic events, potentially improving long-term patient management and outcomes.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Gen Thorac Cardiovasc Surg Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Japón
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Gen Thorac Cardiovasc Surg Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Japón