Early Reintervention To The Distal Residual Aorta After Surgery For Type A Aortic Dissection
Zanxin Wang, Rong Ren, Junmin Wen, Weixin Chen, Minxin Wei.
Shenzhen Sun Yat-sun Cardiovascular Hospital, Shenzhen, China.
Background: The treatment with type A aortic dissection is an area of ongoing development. Conventional and hybrid procedures have their own advantages. However, the initial operation is only the first step. Small true lumen size, malperfusion, dilatation of the residual distal aorta are potential risk factors. The present study retrospectively reviewed patients underwent further therapy to distal part of aorta after central repair. Methods: From 2012 to 2016, 132 patients suffered Stanford A aortic dissection. Fifty-eight patients received conventional surgery and 74 underwent hybrid procedure. Twenty patients received reintervention within 3 months after central surgery. Thirteen of them were after conventional surgery, and 7 were after hybrid procedure. Follow-up time: 2-38 months. Diameters of total aortic, true and false lumen were measured at different anatomic locations: the carina and the celiac artery. True lumen index (true lumen/total aortic diameter, goal=1) was calculated to evaluate the impact of reintervention on remodeling of the descending aorta. Results: There were no death, stroke or spinal cord injury happened. Thoracic false lumen thrombosis was achieved in all patients. The reintervention (endovascular therapy) significantly expanded the true lumen and reduced the false lumen (P < 0.05). False lumen was absorbed at ascending aorta, arch and level of the carina in all patients. True lumen index increased significantly in residual distal aorta (P < 0.05). Conclusions: In these early results, endovascular therapy to residual in distal aorta after central therapy is effective in remodeling the dissected descending aorta.
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