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Title: Extent of preoperative false lumen thrombosis does not influence long-term survival in patients with acute type a aortic dissection
Authors: Larsen, M.
Bartnes, K.
Tsai, T. T.
Eagle, K. A.
Evangelista, A.
Nienaber, C. A.
Suzuki, Toru
Fattori, R.
Froehlich, J. B.
Jutchison, S.
Sundt, T. M.
Januzzi, J. L.
Isselbacher, E. M.
Montgomery, D. G.
Myrmel, T.
First Published: 1-Jul-2013
Publisher: American Heart Association
Citation: Journal of the American Heart Association, 2013, 2 (4), p. e000112
Abstract: Background: Partial thrombosis of the false lumen has been related to aortic growth, reoperations, and death in the chronic phase of type B and repaired type A aortic dissections. The impact of preoperative false lumen thrombosis has not been studied previously. We used data from a contemporary, multinational database on aortic dissections to evaluate whether different degrees of preoperative false lumen thrombosis influenced long‐term prognosis. Methods and Results: We examined the records of 522 patients with surgically treated acute type A aortic dissections who survived to discharge between 1996 and 2011. At the preoperative imaging, 414 (79.3%) patients had patent false lumens, 84 (16.1%) had partial thrombosis of the false lumen, and 24 (4.6%) had complete thrombosis of the false lumen. The annual median (interquartile range) aortic growth rates were 0.5 (−0.3 to 2.0) mm in the aortic arch, 2.0 (0.2 to 4.0) mm in the descending thoracic aorta, and similar regardless of the degree of false lumen thrombosis. The overall 5‐year survival rate was 84.7%, and it was not influenced by false lumen thrombosis (P=0.86 by the log‐rank test). Independent predictors of long‐term mortality were age >70 years (hazard ratio [HR], 2.34; 95% confidence interval [CI], 1.20 to 4.56, P=0.012) and postoperative cerebrovascular accident, coma, and/or renal failure (HR, 2.62; 95% CI, 1.40 to 4.92, P=0.003). Conclusions: Patients with acute type A aortic dissection who survive to discharge have a favorable prognosis. Preoperative false lumen thrombosis does not influence long‐term mortality, reintervention rates, or aortic growth.
DOI Link: 10.1161/JAHA.113.000112
ISSN: 2047-9980
Version: Publisher Version
Status: Peer-reviewed
Type: Journal Article
Rights: Copyright © 2013 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley-Blackwell. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
Appears in Collections:Published Articles, Dept. of Cardiovascular Sciences

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