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

研究成果: ジャーナルへの寄稿学術論文査読

14 被引用数 (Scopus)

抄録

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.

本文言語英語
ページ(範囲)500-504
ページ数5
ジャーナルClinical Cardiology
35
8
DOI
出版ステータス出版済み - 08-2012
外部発表はい

All Science Journal Classification (ASJC) codes

  • 循環器および心血管医学

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