title: Early and Mid-term Changes of the Distal Aorta after Total Arch Replacement for Acute Type A Aortic Dissection.
abstract: BACKGROUND
  Total arch replacement (TAR) is being more widely performed due to recent advances in operative techniques and cerebral protective strategies. In this study, the authors reviewed the relationship between TAR and early- and mid-term changes of the false lumen after TAR in acute type A aortic dissection.
  
  
  METHODS
  Twenty-six patients (aged, 54.7±13.3 years) who underwent TAR for acute type A dissection between June 2004 and February 2012 were reviewed. The relationship between the percentage change in the aortic diameter and the false lumen patency status was assessed by examining the early and late postoperative computed tomography imaging studies.
  
  
  RESULTS
  There were two in-hospital mortalities, one late death, and three follow-up loses. The mean follow-up duration for the final 21 patients studied was 54±19.0 months (range, 20 to 82 months). The incidence of false lumen thrombosis within 2 weeks of surgery in the proximal, middle, and distal thoracic aorta, and the suprarenal and infrarenal abdominal aorta were 67%, 38%, 38%, 48%, and 33%, respectively, and 57%, 67%, 52%, 33%, and 33% for those examined at a mean of 49±18 months after surgery, respectively. The false lumen regressed in 11 patients (42.3%). The aortic diameters were larger in the patients with a patent false lumen than those with a thrombosed false lumen at all levels of the descending aorta (p<0.05).
  
  
  CONCLUSIONS
  TAR and a more complete primary tear-resection can be accomplished with a relatively low-risk of morbidity and mortality. Enlargement of the distal aorta significantly correlated with the false lumen patency status.
authors: Department of Thoracic and Cardiovascular Surgery, Gachon University Gil Medical Center, Gachon University, Korea.
authors: Chang Hu
authors: CH
authors: Choi
authors: Chul Hyun
authors: CH
authors: Park
authors: Yang Bin
authors: YB
authors: Jeon
authors: So Young
authors: SY
authors: Lee
authors: Jae Ik
authors: JI
authors: Lee
authors: Kook Yang
authors: KY
authors: Park
keywords: Aorta; Aortic arch; Aortic dissection