Abstract:
OBJECTIVES:Our aim was to compare aortic remodelling in type B dissections after thoracic endovascular aortic repair (TEVAR) or conservative treatment. METHODS:We conducted a retrospective analysis of computed tomography (CT) data sets at dissection onset and at the last follow-up in a group with conservative (group A) and TEVAR treatment (group B). An additional analysis of the preoperative CT images was performed in patients from group A, who were converted to TEVAR during follow-up. Diameters and lengths of all aortic segments were measured and growth rates were calculated. RESULTS:We included 74 patients: 50 patients in group A (follow-up time: 1625 ± 209 days) and 24 patients in group B (follow-up time: 554 ± 129 days). The mean aortic diameter growth rate was significantly higher in group A than in group B in the mid-descending aorta (A: +7 mm/year; B: -4 mm/year; P = 0.003). Length growth difference was only present in the abdominal aortic segment and was more pronounced in group A (+2 vs ±0 mm/year; P = 0.009). The conversion rate from conservative treatment to TEVAR was 36% (n = 18). A false lumen diameter of >22 mm at baseline was associated with a higher rate of conversion (P = 0.036). After conversion, the mean growth rate in the proximal descending and mid-descending aorta decreased from preoperative +11 and +18 mm/year to postoperative -9 and -14 mm/year, respectively (P < 0.001). CONCLUSIONS:In acute type B dissections, TEVAR stops aortic enlargement in the thoracic aorta, but promotes distal dilatation compared to the conservative treatment group. After conversion to TEVAR in conservatively pretreated chronic type B dissections, a more pronounced diameter decrease in the descending aorta was observed than in patients treated in the acute phase.
journal_name
Interact Cardiovasc Thorac Surgjournal_title
Interactive cardiovascular and thoracic surgeryauthors
Mustafi M,Andic M,Bartos O,Grözinger G,Schlensak C,Lescan Mdoi
10.1093/icvts/ivz285subject
Has Abstractpub_date
2020-03-01 00:00:00pages
458-464issue
3eissn
1569-9293issn
1569-9285pii
5652061journal_volume
30pub_type
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journal_title:Interactive cardiovascular and thoracic surgery
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journal_title:Interactive cardiovascular and thoracic surgery
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journal_title:Interactive cardiovascular and thoracic surgery
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journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,评审
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journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivw392
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journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2011.275933
更新日期:2011-10-01 00:00:00
abstract::Penetrating cardiac injury is rare and frequently not survivable. Significant haemorrhage resulting in cardiac tamponade commonly ensues. Such cardiac tamponade is a clear clinical, radiological and sonographic indicator of significant underlying injury. In the absence of cardiac tamponade, diagnosis can be more chall...
journal_title:Interactive cardiovascular and thoracic surgery
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doi:10.1093/icvts/ivw342
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journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1016/j.icvts.2004.01.019
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journal_title:Interactive cardiovascular and thoracic surgery
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journal_title:Interactive cardiovascular and thoracic surgery
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journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,评审
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journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivz279
更新日期:2020-03-01 00:00:00
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journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2010.246223
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journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2009.211755
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journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,评审
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更新日期:2016-09-01 00:00:00
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journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
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更新日期:2012-07-01 00:00:00
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journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivr037
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journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
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journal_title:Interactive cardiovascular and thoracic surgery
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journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,meta分析,评审
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更新日期:2014-05-01 00:00:00
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journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivt545
更新日期:2014-04-01 00:00:00
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journal_title:Interactive cardiovascular and thoracic surgery
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journal_title:Interactive cardiovascular and thoracic surgery
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journal_title:Interactive cardiovascular and thoracic surgery
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journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,meta分析,评审
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journal_title:Interactive cardiovascular and thoracic surgery
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doi:10.1510/icvts.2007.153601
更新日期:2007-08-01 00:00:00
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