Maximum aortic diameter as a simple predictor of acute type B aortic dissection.
OBJECTIVE
To identify the most prognostic predictor of Stanford type B aortic dissection at admission.


METHODS
Forty-three patients with Stanford type B aortic dissection were divided into two groups: (1) those who developed dissection-related events later (EV group: n = 18), including the need for surgery (n = 12), rupture (n = 1), dissection-related death (n = 5), and aortic enlargement > or =5 mm in diameter per year (n = 15); (2) those without later events (NoEV group: n = 25). Clinical features, aortic diameters, and blood flow status were compared.


RESULTS
The maximum aortic diameter at admission was 41.5 +/- 1.7 mm for the EV group, which was significantly greater than the NoEV group (34.4 +/- 0.9 mm, p <0.001). A maximum aortic diameter > or =40 mm was found in 11 patients (61%) of the EV group, whereas this maximum was found in 4 (16%) of the NoEV group (p = 0.004). A patent false lumen at admission was found in all patients of the EV group and in 17 (68%) of the NoEV group (p = 0.013). Other factors were not significant. A Cox hazard analysis indicated a maximum aortic diameter > or =40 mm as a significant predictor for dissection-related events (hazard ratio 3.13, p = 0.032). The presence of a patent false lumen did not reach a statistical significance.


CONCLUSIONS
Our results indicated that a maximum aortic diameter > or =40 mm at admission was the most prognostic factor for developing late dissection-related events, rather than the presence of a patent false lumen.
Takahashi
Junichiro
J
Division of Cardiovascular Surgery, Aishin Memorial Hospital, Sapporo, Japan.
Wakamatsu
Yutaka
Y
Okude
Jun
J
Kanaoka
Tsuyoshi
T
Sanefuji
Youichi
Y
Gohda
Toshihiro
T
Sasaki
Shigeyuki
S
Matsui
Yoshiro
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000401:mortality / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D015901:Angiography, Digital Subtraction; D001011:Aorta / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D001014:Aortic Aneurysm / Q000401:mortality / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D001019:Aortic Rupture / Q000401:mortality / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D001027:Aortography; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012039:Regional Blood Flow; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects