[Fate of the false lumen after surgery and assessment of operative procedure for DeBakey IIIb dissecting aortic aneurysm].
Eighteen patients with DAA IIIb were divided into two groups. Seven patients with major abdominal arteries originated from true lumen (group I) and 11 ones with renal artery or arteries from false lumen (group II). group I: In early postoperative phase (25-55 days), the descending aortic false lumen had been thrombo-occluded in all patients and the upper abdominal aortic false lumen had been still enhanced in three. In late postoperative phase (9-35 mos.), false lumen had been disappeared in three patients, so those aortae appeared normal morphologically and in other three patients thrombo-occluded false lumen reduced in size. group II: There were re-entries and the false originated renal arteries were well perfused in all patients. In nine patients with no leakage at anastomotic site, these descending aortic false lumens were thrombo-occluded. But as in the upper abdominal aortic false lumens, there was still enough blood flow to perfuse the false originated renal arteries. These suggest that the complete entry closure is the most important, so we recommend to graft the descending aorta containing entry with prosthesis, and this operation leads false lumen to 1) thrombo-occlusion, 2) absorption of thrombus and finally 3) normalization of injured aorta morphologically.
Tamaki
S
S
Department of Cardiovascular Surgery, National Cardiovascular Center, Osaka, Japan.
Nakajima
N
N
Ando
A
A
Uemura
S
S
Adachi
S
S
Fujita
T
T
D000328:Adult; D000784:Aortic Dissection / Q000601:surgery*; D001012:Aorta, Abdominal; D001013:Aorta, Thoracic; D001014:Aortic Aneurysm / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged