Cervical branch dissection is a risk factor of patent false lumen after surgical repair of type A aortic dissection

Shintaroh Koizumi, Soichi Asano, Naoki Hayashida, Kozo Matsuo, Masashi Kabasawa, Shinichiro Abe, Hideomi Hasegawa, Hiroyuki Ikeuchi, Takahiro Ito, Hirokazu Murayama

Chiba cerebral and cardiovascular center, Ichihara, Japan

Date, time and location: 2018.05.25 13:30, Exhibition area, 1st Floor. Zone – C

Abstract

Objective: Patent false lumen after surgical repair of type A aortic dissection is thought to be a risk factor of late aortic aneurysm formation. However, preoperative risk factor of patent false lumen after ascending aorta replacement for type A aortic dissection is unclear.

Methods: We evaluated 57 patients underwent ascending aorta replacement for type A aortic dissection between April 2008 and December 2016 in our hosipital.

Results: Operaive mortality was 3.5% (2 of 57). 53 patients was performed contrast enhanced computed tomography in hospital and 19 patients (35.8%) had patent false lumen. During follow up period (43±34 months), aneurysm formation at aortic arch or descending aorta occurred in 19 patients (35.8%) and patent false lumen was shown its risk factor in univariate analysis (OR: 5.03, p < 0.05). Age(P < 0.01), Marfan(p < 0.05) and cervical branch dissection(p<0.01) were shown preoperative risk factors of postoperative patent false lumen in univariate analysis but primary tear resection (p = 0.66) was not. In multivariate analysis, Age (OR:1.05, p = 0.39) and Cervical branch dissection (OR:5.99, p = 0.01) were shown risk factors of postoperative patent false lumen.

Conslusions: We should perform extending operation such as total arch replacement for young patients with cervical branch dissection even if primary tear resection can be completed by ascending aorta replacement.