Surgical Strategy for Retrograde Type A Aortic Dissection Based on Long-Term Outcomes Keiji Kamohara, MD, Kojiro Furukawa, MD, Shugo Koga, MD, Junji.

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Surgical Strategy for Retrograde Type A Aortic Dissection Based on Long-Term Outcomes Keiji Kamohara, MD, Kojiro Furukawa, MD, Shugo Koga, MD, Junji Yunoki, MD, Hiroyuki Morokuma, MD, Ryo Noguchi, MD, Kojiro Takase, MD, Atsuhisa Tanaka, MD, Shigeki Morita, MD The Annals of Thoracic Surgery Volume 99, Issue 5, Pages 1610-1615 (May 2015) DOI: 10.1016/j.athoracsur.2014.12.059 Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Actuarial survival curves. Five-year and 10-year actuarial survival rates were 84.4% and 84.4% in AAR group, 100% and 80% in TAR-R[–] group, and 100% and 100% in TAR-R[+] group, respectively, with no significant differences between groups. (POD = postoperative day.) The Annals of Thoracic Surgery 2015 99, 1610-1615DOI: (10.1016/j.athoracsur.2014.12.059) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Actuarial aorta-related event-free curves. Five-year and 10-year aorta-related event-free rates were 89.3% and 65.1% in the AAR group, 100% and 100% in the TAR-R[–] group, and 75% and 50% in the TAR-R[+] group, respectively, with no significant differences between the groups. (POD = postoperative day.) The Annals of Thoracic Surgery 2015 99, 1610-1615DOI: (10.1016/j.athoracsur.2014.12.059) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Status of late thrombosis in the remaining false lumen. (A) In proximal site (from distal arch to proximal descending aorta), a significantly higher patency rate was observed in the ascending aortic replacement (AAR) group (8 of 18 cases) than in the total arch replacement (TAR) group (1 of 17 cases; p = 0.009), including TAR-R[–] group (1 of 12 cases; p = 0.03). (B) In distal site (from distal descending aorta to abdominal aorta), there were no significant differences between the AAR and TAR groups. (TAR-R[–] = total arch replacement without resection of a primary tear; TAR-R[+] = total arch replacement with resection of a primary tear.) The Annals of Thoracic Surgery 2015 99, 1610-1615DOI: (10.1016/j.athoracsur.2014.12.059) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Actuarial late aortic expansion (> 50 mm)–free rates at 5 and 10 years were 64.9% and 48.1% in ascending aortic replacement (AAR) group, 88.9% and 88.9% in the TAR-R[–] group, and 100% and 100% in the TAR-R[+] group, respectively, with a significantly lower rate in the AAR group (p = 0.04). (POD = postoperative day; TAR-R[–] = total arch replacement without resection of a primary tear; TAR-R[+] = total arch replacement with resection of a primary tear.) The Annals of Thoracic Surgery 2015 99, 1610-1615DOI: (10.1016/j.athoracsur.2014.12.059) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions