Key result
Type A aortic dissection surgery leaves a patent false channel in ~83% of patients.
Observational (n=129)
Postoperative patency of the false channel in type A aortic dissection is highly prevalent (82.9%) and can be explained by persistent primary tears, iatrogenic tears, or retrograde filling from supra-aortic vessels.
High false lumen patency after type A dissection repair warrants close surveillance; leaves open optimal strategies to promote thrombosis.
PURPOSE: To understand why the false channel (FC) remains patent after surgery of type A acute aortic dissection (TAAAD). MATERIALS AND METHODS: Postoperative contrast-enhanced computed tomography scans of 129 patients operated for TAAAD were analyzed, and a color-Doppler ultrasound examination (CDUS) of the supra-aortic vessels (SAVs) was performed in 12 patients. RESULTS: The FC remained patent in 107 (82.9%) patients. The entry site was situated near the distal anastomosis in 43 (40.2%) patients and far from it in 44 (41.1%) patients. In 10 (9.35%) patients, an entry site was observed only in the SAVs. In 10 (9.35%) patients, no entry site was seen. Of the 12 patients explored with CDUS, a retrograde filling of the FC was observed in 11 patients. CONCLUSION: The frequent postoperative circulating aortic FC can be explained by the persistence of the primary entry tear, the presence of iatrogenic tears, and/or a retrograde filling in the SAVs.
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Bing et al. (2014) conducted an observational in Type A acute aortic dissection (TAAAD) (n=129). Surgery for type A acute aortic dissection was evaluated on Patent false channel. Following surgery for type A acute aortic dissection, the false channel remained patent in 82.9% of patients.
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