[Comparison between pre- and post-operative renal function and fate of the false lumen after surgical treatment of dissecting aortic aneurysms].
Twenty-seven patients, whose renal artery (or arteries) originated from false lumen, were studied dividing into two groups based on pre-operative renal state. Group I, without morphological and functional disorder, did not show any change pre- and post-operatively. Post-operative angiography indicated that pre-operative re-entry played as a entry to perfuse the false lumen originated renal artery (or arteries). In group II, with morphological and/or functional disorder, renal arteries, with reduced flow or non-perfused, originated from false lumen in 4 patients and true lumen in 4. Kidney perfused by those arteries had been disturbed morphologically more or less. So, it was not only the reason of renal disturbance that the false lumen originated arteries perfused that kidney. Post-operative enhanced body CT showed that false lumen of descending Ao without major entry or leakage at the site of anastomosis was occluded completely by thrombus formation in 11 of 12 patients. In those 11 patients, false lumen of upper abdominal Ao did not have any thrombus formation and gave enough flow to perfuse kidney. Those suggest that the operation resecting entries does not influence the renal function, the reason of renal disorders in DAA is not to be perfused by false lumen originated arteries but a grade and duration of renal ischemia and the residual flow of false lumen decides making thrombus formation or not.
Tamaki
S
S
Nakajima
N
N
Kawazoe
K
K
Ando
A
A
Fujita
T
T
D000784:Aortic Dissection / Q000503:physiopathology / Q000601:surgery*; D001014:Aortic Aneurysm / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012079:Renal Circulation