Impact of aortic dimensions and pulse pressure on late aneurysm formation in operated type A aortic dissection. A magnetic resonance imaging study.

• Type: Article in International Scientific Journal
• Date: 2008

Authors

Almeida AG (Author) Other; Nobre AL (Author) Other; Pereira RA (Author) Other; Costa - Pereira A (Author) FMUP; Tavares C (Author) FMUP; Cravino J (Author) Other; Lopes MG (Author) Other

Journal

Title: International Journal of Cardiovascular Imaging

Vol. 24 No. 6

Pages: 633-640

ISSN: 1569-5794

Publisher: Springer Nature

Indexing

ISI Web of Science

Scopus

Pubmed / Medline

Other information

Abstract (EN): Abstract: Background Patients operated on for type A aortic dissection remain at risk of long-term aneurysm development, the main cause for late death. The aim of this study was to identify early predictors for aneurysm formation at three-years after surgery. Methods A study group of 70 consecutive patients (52 +/- 10 years-old, 41 male), operated on for aortic dissection with replacement of the ascending segment, was evaluated prospectively for three-years. In order to detect aneurysm formation, the dimension of residual distal aortic segments was obtained soon after surgery and then annually for three years using cardiovascular magnetic resonance. Results During follow-up (38 +/- 2.6 months), aneurysm was found in 25 patients (35%) involving residual segments. Larger initial dimension of segments, higher pulse pressure, lower distensibility of residual segments and the presence of a residual flap were univariately associated with aneurysm. Multivariate analysis identified the initial dimension (mm) of the descending thoracic aorta (OR 1.47, 95% CI: [1.19 - 1.82]) and pulse pressure (OR 1.43,95% CI: [1.10 - 1.86]) as independent variables for aneurysm formation. A risk score using pulse pressure and descending thoracic dimension was constructed. Patients with <= 24 points had no late aneurysm formation, while those with a score >= 45 yielded 100% of aneurysm frequency. Conclusions Type A aortic dissection treated by graft interposition is associated with a high risk of aneurysm formation. Early post-operative pulse pressure and the descending thoracic aortic dimension were independent variables and seem to be the main predictors for the outcome.

Language: Portuguese

Type (Professor's evaluation): Scientific