The changes of aortic diameter after aortic repair with aortic tailoring technique for chronic type B aortic dissection

OBJECTIVES: Aortic repair with aortic tailoring of the false lumen can preserve the true lumen and intercostal arteries naturally. It is a useful surgical strategy to prevent paraplegia. However, aortic remodelling of tailored segments in a late phase after surgery is another concern. This study investigates the destiny of aortic remodelling of tailored aorta. METHODS: From June 2004 to April 2013, 21 consecutive patients underwent aortic tailoring operation for chronic type B aortic dissecting aneurysm. The mean age at operation was 60 ± 10 years (range, 43-77). The tailored aortic segments were followed by serial CT scanning with the mean follow-up period of 46 ± 32 months (range, 2-103). RESULTS: There were no operative deaths but paraplegia in 1, stroke in 1 and reversible renal failure in 2 patients. There were two late deaths: one due to pneumonia and the other due to aneurysmal rupture of the abdominal aorta. Eighteen patients revealed a completely thrombosed false lumen and no expansion of the tailored aorta, with it remaining less than 40 mm in diameter during follow-up. However, 3 cases were associated with a patent false lumen and 2 cases revealed aortic events. The aortic event-free rate at 5 years was 95 ± 5.1% in all patients and 66 ± 27% in patients in the patent false lumen group. CONCLUSIONS: Aortic tailoring is a useful surgical technique for chronic type B aortic dissection. Paraplegia and ischaemia of other visceral organs could less likely occur. Patients with a completely thrombosed false lumen revealed no aortic events; however, a patent false lumen was associated with a high risk of aortic events.