Acute type B aortic dissection with communicating vs. non-communicating false lumen.
BACKGROUND
In practice, patients with acute aortic dissection (AAD) are generally divided into 2 groups according to the status of the false lumen: non-communicating or communicating. The similarities and differences between the 2 groups, however, have not been fully determined in a large population. METHODS AND RESULTS: We studied 502 patients with Stanford type B AAD. Clinical background at symptom onset was compared, and similarities and differences characterized, for patients with non-communicating (NC group, n=288) vs. communicating (C group, n=214) false lumens. Time of day (00.00-06.00 hours, 06.00-12.00 hours, 12.00-18.00 hours, and 18.00-24.00 hours) and extent of physical activity (extreme exertion, slight exertion, at rest, and sleeping) at symptom onset were similar between groups. Patients in the NC group were older (mean age, 71±11 years vs. 64±14 years, P<0.01) and had lower prevalence of distally extended aortic dissection (26% vs. 8%, P<0.01) and deaths in hospital (2% vs. 7%, P=0.011) than those in the C group.


CONCLUSIONS
At symptom onset, clinical circumstances and physical activity were similar between the groups, and old age and a background of DeBakey IIIa aortic dissection may be associated with determination of false lumen status. The outcome in the NC group was better than in the C group.
Tokyo CCU Network Scientific Committee; Division of Cardiovascular Intensive Care, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-ku 113-8603. koichi-a@nms.ac.jp
Koichi
K
Akutsu
Hideaki
H
Yoshino
Tetsuya
T
Tobaru
Kenichi
K
Hagiya
Yusuke
Y
Watanabe
Keiji
K
Tanaka
Nobuya
N
Koyama
Takeshi
T
Yamamoto
Ken
K
Nagao
Morimasa
M
Takayama
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001019:Aortic Rupture / Q000145:classification* / Q000453:epidemiology* / Q000473:pathology*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence