Clinical Outcomes of the Location of Primary Intimal Entry in Stanford A Aortic Dissection

Qing Zhou, Albert Y. Xue, Liang Pan, Dongjin Wang

Department of Thoracic and Cardiovascular Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China

Date, time and location: 2018.05.27 08:30, Congress Hall, 2F–B

Abstract

Objective: Primary intimal entry is the leading cause of aortic dissection. The relationships between the location of primary intimal entry in Stanford A aortic dissection and the clinical manifestation and outcomes are not clearly.

Methods: From January 2011 to December 2016, 476 TAAD patients (365 male, 111 female) were enrolled in this retrospective research. With the aid of Preoperative CT scan and intraoperative observing, we confirmed the location of primary intimal entry of all patients, the results revealed that 229 patients with primary intimal entry in the ascending aorta (Group As), 90 patients located in the aortic arch (Group Ar)and 157 patients in the other site or with multiple location (Group O). The clinical data and perioperative information were analyzed related to the location of primary intimal entry.

Results: The ratio of hypertension was higher in the Group Ar (84.44%, p=0.06), while the ratio of Marfan syndrome was significantly lower in the Group O (0.64%, p=0.06). Cerebral malperfusion distributed differently and more predominant in Group As and Group Ar, and more patients with aortic valve regurgitation (Grade≥2) were in Group As. As different range of dissection inducing by different location of intimal entry, we have performed different surgical methods. More root replacement operations in Group Ar and more total arch replacement in Group As. With similar operative time, ICU stay was shorter in Group Ar. Mortality and morbidity were similar in all patients.

Conclusions: The clinical manifestation and clinical outcomes were different according to the location of primary intimal location in patients with Stanford A aortic dissection.