Chapter 14

Effects of False Lumen Patency on the Residual Dissected Thoracic Aorta after Repair of Acute Type A Aortic Dissection

Meng-Ta Tsai, Yi-Shan Tsai and Chwan-Yau Luo

Abstract

Patients who survive the initial operation of acute type A aortic dissection (TAAAD) still face the risk of aneurysm formation and rupture of the residual dissected aorta. Although surveillance of the postoperative distal aortic size is the current standard of follow-up and indication of reoperation, several parameters of false lumens have been analyzed in order to earlier identify the subgroup at risk for adverse aortic events. The associations between postoperative false lumen patency and late aortic growth, aneurysm formation, and the reoperation rate have been extensively investigated and generally accepted. Controversies do exist, however, and more detailed studies of false lumen status, including the role of partial thrombosis and the character of tear entries, have challenged the effectiveness of prognosis prediction based on false lumen patency alone. These parameters of false lumens will change our concept of postoperative follow-up and may potentially improve the long-term outcome of TAAAD by earlier selection of patients who will benefit from secondary interventions.

Total Pages: 299-318 (20)

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