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. 1996 Jan;75(1):62–66. doi: 10.1136/hrt.75.1.62

Fate of the native aorta after repair of acute type A dissection: a magnetic resonance imaging study.

N R Moore 1, A J Parry 1, B Trottman-Dickenson 1, R Pillai 1, S Westaby 1
PMCID: PMC484224  PMID: 8624875

Abstract

OBJECTIVE--To determine late patency of the aortic false lumen and propensity for aneurysm formation after repair of type A dissection. DESIGN--Retrospective follow up study. SETTING--Regional cardiac surgical unit. PATIENTS--28 patients after repair of type A dissection. METHODS--Magnetic resonance imaging (MRI) was performed between 6 weeks and 12 months after operation. RESULTS--A patent distal false lumen with demonstrable blood flow was found in 22 patients (78%). Only six patients had complete obliteration of the false lumen by thrombus. The conduct of operation did not influence this. Nine patients (32%) showed aneurysmal dilatation of the false lumen and three had a repeat operation. CONCLUSIONS--So-called "successful repair" of aortic dissection does not obliterate the distal false lumen. MRI is a safe and effective radiological procedure for determining patency and dilatation in the false lumen. Patients with type A dissection with blood flow in the false lumen should be studied every 6 months to look for aneurysmal dilatation.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Cooley D. A., Livesay J. J. Technique of "open" distal anastomosis for ascending and transverse arch resection. Cardiovasc Dis. 1981 Sep;8(3):421–426. [PMC free article] [PubMed] [Google Scholar]
  2. DeBakey M. E., McCollum C. H., Crawford E. S., Morris G. C., Jr, Howell J., Noon G. P., Lawrie G. Dissection and dissecting aneurysms of the aorta: twenty-year follow-up of five hundred twenty-seven patients treated surgically. Surgery. 1982 Dec;92(6):1118–1134. [PubMed] [Google Scholar]
  3. Erbel R., Engberding R., Daniel W., Roelandt J., Visser C., Rennollet H. Echocardiography in diagnosis of aortic dissection. Lancet. 1989 Mar 4;1(8636):457–461. doi: 10.1016/s0140-6736(89)91364-0. [DOI] [PubMed] [Google Scholar]
  4. Erbel R., Oelert H., Meyer J., Puth M., Mohr-Katoly S., Hausmann D., Daniel W., Maffei S., Caruso A., Covino F. E. Effect of medical and surgical therapy on aortic dissection evaluated by transesophageal echocardiography. Implications for prognosis and therapy. The European Cooperative Study Group on Echocardiography. Circulation. 1993 May;87(5):1604–1615. doi: 10.1161/01.cir.87.5.1604. [DOI] [PubMed] [Google Scholar]
  5. Galloway A. C., Colvin S. B., Grossi E. A., Parish M. A., Culliford A. T., Asai T., Rofsky N. M., Weinreb J. C., Shapiro S., Baumann F. G. Surgical repair of type A aortic dissection by the circulatory arrest-graft inclusion technique in sixty-six patients. J Thorac Cardiovasc Surg. 1993 May;105(5):781–790. [PubMed] [Google Scholar]
  6. Gott V. L., Pyeritz R. E., Cameron D. E., Greene P. S., McKusick V. A. Composite graft repair of Marfan aneurysm of the ascending aorta: results in 100 patients. Ann Thorac Surg. 1991 Jul;52(1):38–45. doi: 10.1016/0003-4975(91)91414-q. [DOI] [PubMed] [Google Scholar]
  7. Guilmet D., Bachet J., Goudot B., Laurian C., Gigou F., Bical O., Barbagelatta M. Use of biological glue in acute aortic dissection. Preliminary clinical results with a new surgical technique. J Thorac Cardiovasc Surg. 1979 Apr;77(4):516–521. [PubMed] [Google Scholar]
  8. Kersting-Sommerhoff B. A., Higgins C. B., White R. D., Sommerhoff C. P., Lipton M. J. Aortic dissection: sensitivity and specificity of MR imaging. Radiology. 1988 Mar;166(3):651–655. doi: 10.1148/radiology.166.3.3340758. [DOI] [PubMed] [Google Scholar]
  9. Nienaber C. A., Spielmann R. P., von Kodolitsch Y., Siglow V., Piepho A., Jaup T., Nicolas V., Weber P., Triebel H. J., Bleifeld W. Diagnosis of thoracic aortic dissection. Magnetic resonance imaging versus transesophageal echocardiography. Circulation. 1992 Feb;85(2):434–447. doi: 10.1161/01.cir.85.2.434. [DOI] [PubMed] [Google Scholar]
  10. Nienaber C. A., von Kodolitsch Y., Nicolas V., Siglow V., Piepho A., Brockhoff C., Koschyk D. H., Spielmann R. P. The diagnosis of thoracic aortic dissection by noninvasive imaging procedures. N Engl J Med. 1993 Jan 7;328(1):1–9. doi: 10.1056/NEJM199301073280101. [DOI] [PubMed] [Google Scholar]
  11. Petasnick J. P. Radiologic evaluation of aortic dissection. Radiology. 1991 Aug;180(2):297–305. doi: 10.1148/radiology.180.2.2068287. [DOI] [PubMed] [Google Scholar]
  12. Roberts C. S., Roberts W. C. Aortic dissection with the entrance tear in the descending thoracic aorta. Analysis of 40 necropsy patients. Ann Surg. 1991 Apr;213(4):356–368. doi: 10.1097/00000658-199104000-00011. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Vasile N., Mathieu D., Keita K., Lellouche D., Bloch G., Cachera J. P. Computed tomography of thoracic aortic dissection: accuracy and pitfalls. J Comput Assist Tomogr. 1986 Mar-Apr;10(2):211–215. doi: 10.1097/00004728-198603000-00008. [DOI] [PubMed] [Google Scholar]
  14. White R. D., Ullyot D. J., Higgins C. B. MR imaging of the aorta after surgery for aortic dissection. AJR Am J Roentgenol. 1988 Jan;150(1):87–92. doi: 10.2214/ajr.150.1.87. [DOI] [PubMed] [Google Scholar]

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