Can we predict the site of entry tear by computed tomography in patients with acute type a aortic dissection?

Yoshiyuki Takami, Kazuyoshi Tajima, Wataru Kato, Kei Fujii, Makoto Hibino, Hisaaki Munakata, Kenichiro Uchida, Yoshimasa Sakai

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)

Abstract

Background: In patients with acute type A aortic dissection (AAD), localization of the primary entry tear to be excluded is of major importance for intervention. Hypothesis: There are reliable indirect computed tomography (CT) findings to predict the entry site. Methods: In 83 patients with type A AAD whose primary entry tears were identified surgically between 2003 and 2009, we retrospectively examined the diagnostic CT scans regarding pericardial effusion, the largest short-axial diameter of the aorta, widths of true and false lumens, and false lumen thrombosis at 6 levels of thoracic aorta from the aortic root to the descending aorta. Results: The primary entry sites identified intraoperatively were proximal ascending in 21 patients, middle ascending in 21, distal ascending in 21, arch in 17, and descending or unknown in 16. The multivariate logistic analysis revealed that pericardial effusion (odds ratio [OR]: 2.2, 95% confidence interval [CI]: 1.2-3.4, P < 0.001) and dilated ascending aorta (OR: 1.6, 95% CI: 1.1-2.4, P = 0.012) were the significant CT findings to predict the entry tear in the ascending aorta. It also revealed that the significant CT finding to predict the entry tear distal to the aortic arch was nonthrombosed false lumen in the descending aorta (OR: 1.2, 95% CI: 1.1-2.1, P = 0.048). Conclusions: We can predict the primary entry site by the preoperative CT findings in patients with type A AAD, considering pericardial effusion, aortic diameter, widths of true and false lumens, and false lumen thrombosis at different anatomic levels.

Original languageEnglish
Pages (from-to)500-504
Number of pages5
JournalClinical Cardiology
Volume35
Issue number8
DOIs
Publication statusPublished - 08-2012
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Fingerprint

Dive into the research topics of 'Can we predict the site of entry tear by computed tomography in patients with acute type a aortic dissection?'. Together they form a unique fingerprint.

Cite this