title: Acute type-A aortic dissection with patent false lumen through to the abdominal aorta: effects of a conventional elephant trunk on malperfusion syndromes and narrowed true lumen.
abstract: BACKGROUND
  Narrowed true lumen and patent false lumen through to the terminal aorta is a high-risk condition for malperfusion syndromes (MS) in acute type-A aortic dissection. It is important to ascertain how the true and false lumens behave after surgery.
  
  
  METHODS
  We retrospectively investigated 45 patients with this pathology. The true lumen sizes at the narrowest levels above and below the superior mesenteric artery were followed by computed tomography after surgery (0-36 months).
  
  
  RESULTS
  Thirty-seven MS were seen in 23 patients. Hospital mortality was 8.9%. The narrowed true lumen was not enlarged in the first 6 months with a patent false lumen. The elephant trunk procedure did not improve the true lumen size. An extremely narrowed (≤3 mm) true lumen was associated with a significantly high incidence of MS and mortality.
  
  
  CONCLUSIONS
  High incidences of MS were observed in this particular pathology. An extremely narrowed true lumen was accompanied by a high incidence of MS and mortality.
authors: Department of Cardiovascular Surgery, Nippon Medical School Musashikosugi Hospital, Kawasaki, Kanagawa, Japan himura@nms.ac.jp.
authors: H
authors: H
authors: Imura
authors: Nippon Medical School Hospital, Tokyo, Japan.
authors: M
authors: M
authors: Tanoue
authors: Nippon Medical School Hospital, Tokyo, Japan.
authors: M
authors: M
authors: Shibata
authors: Department of Cardiovascular Surgery, Nippon Medical School Musashikosugi Hospital, Kawasaki, Kanagawa, Japan.
authors: Y
authors: Y
authors: Maruyama
authors: Department of Cardiovascular Surgery, Nippon Medical School Musashikosugi Hospital, Kawasaki, Kanagawa, Japan.
authors: M
authors: M
authors: Shirakawa
authors: Nippon Medical School Hospital, Tokyo, Japan.
authors: M
authors: M
authors: Ochi
mesh_terms: D000368:Aged; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery; D001019:Aortic Rupture / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery; D001027:Aortography; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D008297:Male; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging / Q000601:surgery; D008875:Middle Aged; D012189:Retrospective Studies; D013577:Syndrome; D014057:Tomography, X-Ray Computed
keywords: acute aortic dissection; elephant trunk; malperfusion syndrome; narrowed true lumen; surgery