Risk Factors for Descending Aortic Aneurysm Formation in Medium-Term Follow-up of Patients With Type A Aortic Dissection

Impact of aortic dimensions and pulse pressure on late aneurysm formation in operated type A aortic dissection. A magnetic resonance imaging study

“…We found significant risk of aneurysm along the residual aorta, mainly on the thoracic segments, as described by others [1][2][3][4][5]. Risk factors, follow-up time and [8][9][10][11][12]. From the possible predictors for aneurysm, in addition to overall indicators, segmental variables were also assessed, since the expected differences in the hemodynamic profile and wall composition of different segments could influence outcome [18].…”

“…Patients with Marfan syndrome are highly prone to late aneurysm, and distensibility seems to have a role [4][5][6][7]. However, in non-Marfan patients, risk factors for aneurysm have not been clearly established, as many studies are retrospective or include mainly operative variables [3,[8][9][10][11][12].…”

Total Arch versus Hemiarch Replacement for Type A Acute Aortic Dissection: A Single-Center Experience

“…However, in patients who undergo surgery for type A AAD, a patent false lumen has a well-established prognostic value as the major risk factor for the need to reintervene on the aortic arch or descending aorta. [13][14][15][16][17] Halstead and colleagues 16 found that initial enlargement (>4 cm) of the thoracic descending aorta and patency of the false lumen are the dominant factors associated with subsequent aortic expansion. In monitoring very closely a cohort of 70 patients after surgical intervention for acute type A dissection, Fattori and associates 17 found the annual aortic growth rate to be maximal in the descending aortic segment-and significantly higher in the absence of false luminal thrombosis.…”

Descending endograft for DeBakey type 1 aortic dissection: pro

“…Given the high risk profile of patients with acute aortic dissection and the technical complexity of the necessary interventions, a conservative tear-oriented aortic replacement (more often a supra-coronary ascending/ hemiarch replacement) with commissural resuspension and re-establishment of the dominant blood flow in the distal true lumen currently represents the most common surgical approach. However, it has been demonstrated that the distal false lumen remains patent in about 70% to 80% of patients undergoing surgery for DBT1-AAD dissection (5)(6)(7)(8), and a wide and patent false lumen worsens the prognosis (6,(9)(10)(11)(12)(13)(14)(15)(16) by increasing the risk of late death, re-intervention and aneurysmal dilatation of the remaining dissected aorta (6,(17)(18)(19)(20)(21). The regions with the highest risk of developing an aneurysm are the distal arch and proximal descending thoracic aorta (DTA) (17,(22)(23)(24).…”