Acute Type-A aortic dissection with patent false lumen through to the abdominal aorta: effects of a conventional elephant trunk on malperfusion syndromes and narrowed true lumen

• Published in: Perfusion Vol. 29; no. 5; pp. 417 - 424
• Main Authors: Imura, H, Tanoue, M, Shibata, M, Maruyama, Y, Shirakawa, M, Ochi, M
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.09.2014; Sage Publications Ltd
• Subjects: Aged; Aorta, Abdominal - diagnostic imaging; Aorta, Abdominal - surgery; Aortic Rupture - diagnostic imaging; Aortic Rupture - mortality; Aortic Rupture - surgery; Aortography; Female; Hospital Mortality; Humans; Incidence; Male; Mesenteric Artery, Superior - diagnostic imaging; Mesenteric Artery, Superior - surgery; Middle Aged; Retrospective Studies; Syndrome; Tomography, X-Ray Computed; elephant trunk; narrowed true lumen; acute aortic dissection; malperfusion syndrome; surgery
• ISSN: 0267-6591; 1477-111X
• DOI: 10.1177/0267659113514787

Background: Narrowed true lumen and patent false lumen through to the terminal aorta is a high-risk condition for malperfusion syndromes (MS) in acute type-A aortic dissection. It is important to ascertain how the true and false lumens behave after surgery. Patients and Methods: We retrospectively investigated 45 patients with this pathology. The true lumen sizes at the narrowest levels above and below the superior mesenteric artery were followed by computed tomography after surgery (0-36 months). Results: Thirty-seven MS were seen in 23 patients. Hospital mortality was 8.9%. The narrowed true lumen was not enlarged in the first 6 months with a patent false lumen. The elephant trunk procedure did not improve the true lumen size. An extremely narrowed (≤3mm) true lumen was associated with a significantly high incidence of MS and mortality. Conclusions: High incidences of MS were observed in this particular pathology. An extremely narrowed true lumen was accompanied by a high incidence of MS and mortality.