Type A aortic dissection with arch entry tear: Surgical experience in 104 patients over a 12-year period Wei-Guo Ma, MD, PhD, Wei Zhang, MD, Long-Fei.

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Presentation transcript:

Type A aortic dissection with arch entry tear: Surgical experience in 104 patients over a 12-year period Wei-Guo Ma, MD, PhD, Wei Zhang, MD, Long-Fei Wang, MD, Jun Zheng, MD, PhD, Bulat A. Ziganshin, MD, Paris Charilaou, MD, Xu- Dong Pan, MD, Yong-Min Liu, MD, Jun-Ming Zhu, MD, Qian Chang, MD, John A. Rizzo, PhD, John A. Elefteriades, MD, Li-Zhong Sun, MD The Journal of Thoracic and Cardiovascular Surgery Volume 151, Issue 6, Pages 1581-1592 (June 2016) DOI: 10.1016/j.jtcvs.2015.11.056 Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Flow diagram depicting patient groups based on location of the entry tear. TAAD, Type A aortic dissection. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 1581-1592DOI: (10.1016/j.jtcvs.2015.11.056) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Survival of patients with arch dissections after FET + TAR. CI, Confidence interval. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 1581-1592DOI: (10.1016/j.jtcvs.2015.11.056) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Freedom from adverse events in patients with arch dissections following FET + TAR, including endoleak, coronary artery disease, and malignant arrhythmia. CI, Confidence interval. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 1581-1592DOI: (10.1016/j.jtcvs.2015.11.056) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Preoperative and follow-up CT scans in a 38-year-old man who presented with substernal pain for 2 days. He was diagnosed with acute TAAD with an arch entry tear and underwent emergent surgical repair with FET + TAR. A, Preoperative CT scan. B, CT scan at discharge (1 week). C, CT scan at 3 months. D, Follow-up CT scan at 3 years. E, Follow-up CT scan at 6 years. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 1581-1592DOI: (10.1016/j.jtcvs.2015.11.056) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 Following FET + TAR, both the stented (A) and unstented distal (B) segments showed significant temporal trends toward false lumen shrinkage and true lumen expansion. These trends in the diameter changes of the true lumen (C) and the false lumen and aorta (D) were more evident across the stented segment. The unstented true and false lumens are indicated by dashed lines; the unstented aortic segment, by a dotted line. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 1581-1592DOI: (10.1016/j.jtcvs.2015.11.056) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Following FET + TAR, the stented aortic segment showed significant temporal trends toward false lumen shrinkage and true lumen expansion. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 1581-1592DOI: (10.1016/j.jtcvs.2015.11.056) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions