Key result
A maximum false lumen diameter >1.28 cm on preoperative CTA was associated with a higher probability of negative remodeling after surgery for type A aortic dissection (OR 0.10; 95% CI 0.01-0.51).
Why the study?
Although preoperative aortic diameter relates to aortic remodeling, prognosis should also consider the true lumen and false lumen respectively.
Do preoperative true and false lumen diameters predict aortic remodeling after surgery for type A aortic dissection?
Cohort (n=161)
No
Do preoperative true and false lumen diameters predict aortic remodeling after surgery for type A aortic dissection?
Odds Ratio: 0.1 (95% CI 0.01–0.51)
Preoperative maximum false lumen diameter >1.28 cm on CTA is a significant predictor of negative aortic remodeling after surgery for type A aortic dissection.
May flag higher negative remodeling risk after type A repair; hypothesis-generating and requires prospective validation before guiding decisions.
Background: Although current research revealed the preoperative diameter of the aorta is related to aortic remodeling, prognosis should consider the true lumen (TL) and false lumen (FL) respectively too. Methods: The cohort of this retrospective analysis included 161 type A aortic dissection (TAAD) patients who underwent surgery at a single institution from September 1, 2017, to September 1, 2018. Computed tomography angiography (CTA) images were reviewed to assess changes of the diameters of the TL, FL and total aorta at the levels of the stented segment, distal end of the stent, celiac trunk, and below the renal artery. Results: During the study period, positive remodeling was observed in 33 (20.5%) patients. The probability of negative remodeling far from the stent segment was greater than the aorta close to the stent. Only the TL diameter was associated with each levels' changes and underwent significant change (P<0.05). Multivariate analysis identified aortic regurgitation as a risk factor for remodeling in the distal end of the stent. The maximum diameter of the FL was the only risk factor related to the remodeling type (odds ratio =0.10; 95% confidence interval: 0.01-0.51), a maximum diameter of the FL of >1.28 cm was associated with a higher probability of negative remodeling after surgery (specificity =0.994; sensitivity =0.571; area under the receiver operating characteristic curve =0.76). Conclusions: The TL and FL diameters on preoperative CTA images can be used to assess the risk of negative remodeling after surgery.
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Zhang et al. (2023) conducted a cohort in Type A aortic dissection (TAAD) (n=161). Preoperative maximum diameter of the false lumen was evaluated on Aortic remodeling type (OR 0.10, 95% CI 0.01-0.51). A maximum false lumen diameter >1.28 cm on preoperative CTA was associated with a higher probability of negative remodeling after surgery for type A aortic dissection (OR 0.10; 95% CI 0.01-0.51).
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