ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Thoracic aortic replacement in type-B aortic dissections: midterm results
Ali Kubilay Korkut1, Gürkan Çetin1, Emin Tireli2
1Department of Cardiovascular Surgery, İstanbul University Haseki Cardiology Institute, İstanbul
2Department of Cardiovascular Surgery, Medicine Faculty of İstanbul University, İstanbul
Background: Surgical management of acute and chronic type-B aortic dissections is controversial. Acute type-B aortic dissections complicated by uncontrollable pain, visceral ischemia, malperfusion, and risk for rupture require intervention. We evaluated midterm results of aortic dissections treated surgically.

Methods: The study included 29 patients who underwent surgery for acute (n=14; 12 males, 2 females; mean age 53 years; range 34 to 65 years) and chronic (n=15; 11 males, 4 females; mean age 62 years; range 37 to 74 years) type-B aortic dissections. The patients were evaluated by multislice computed tomography within a mean follow-up period of three years (range 1 to 7 years). Abdominal and descending aortic diameters were measured, and patency of the false lumen, enlargement of the aorta and the false lumen were analyzed.

Results: Two patients from each group died in the early postoperative period. In the acute aortic dissection group, the false lumen was patent in two patients with an enlargement of 8 mm in diameter, but none required reoperation. In the chronic aortic dissection group, the false lumen was patent in eight patients, of which distal anastomosis was performed to both the true and false lumens in six patients, and to the true lumen in two patients. Enlargement of the false lumen was 5 mm in six patients. In this group, three cases in which both the true and false lumens were patent required a subsequent thoracoabdominal aortic replacement because the aortic diameter exceeded 6 cm.

Conclusion: Surgical treatment should be considered in chronic type-B aortic dissections with thoracic aortic diameter measuring 5.5 cm or above. False lumen patency has an adverse influence on the prognosis after surgical treatment of type-B aortic dissections.

Keywords : Anastomosis, surgical; aneurysm, dissecting/surgery; aortic aneurysm/surgery; tomography, X-ray computed
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