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Original Articles: Adult Cardiac

Growth Rate of Affected Aorta in Patients With Type B Partially Closed Aortic Dissection

Department of Radiology, Nagasaki University School of Medicine, Nagasaki, Japan

Accepted for publication June 9, 2009.

^_* Address correspondence to Dr Sueyoshi, Department of Radiology, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan (Email: eijunsueyoshi{at}aol.com).

Background: Our purpose was to evaluate the growth rate (GR) of the affected aorta and to clarify whether a partially closed false lumen can affect aortic enlargement in patients with type B double-barrelled aortic dissection (AD).

Methods: Seventy-one patients (mean age, 64.4 years) who had experienced AD were enrolled in this study. Regular follow-up computed tomography studies (mean, 48.9 months) were performed. During the follow-up period, aortic diameter was measured with computed tomography. The fastest GR was calculated.

Results: Based on final computed tomography findings, the patients were divided into three groups: those with completely closed false lumens (n = 8), those with partially closed false lumens (n = 20), and those with patent false lumens (n = 43). Among the patients with partially closed false lumens, 3 of 20 (15%) had a sac formation type and 17 (85%) had a non–sac formation type. The mean fastest GRs for groups with a completely closed false lumen, partially closed false lumen, and patent false lumen were –0.2 ± 0.6, 4.0 ± 4.3, and 4.9 ± 4.5 mm/year, respectively. The differences among the three groups were statistically significant (p = 0.0149). In the partially closed false lumen group, the mean fastest GRs of the sac and non–sac formation types were 12.7 ± 1.1 and 2.6 ± 2.7 mm/year, respectively; this difference is statistically significant (p = 0.007).

Conclusions: Affected aortas with partially closed false lumens do not exhibit the highest GR. The status of a partially closed false lumen is not a significant risk factor for enlargement; however, careful follow-up study is needed whenever the sac formation type of partially closed false lumen is identified.

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				W. J. Gomes Invited commentary. Ann. Thorac. Surg., October 1, 2009; 88(4): 1257 - 1257. [Full Text] [PDF]