title: Influence of False Lumen Status on the Prognosis of Acute Type A Aortic Dissection without Urgent Surgical Treatment.
abstract: OBJECTIVE
  Recently, much attention has been focused on partial thrombosis of the false lumen in patients with acute aortic dissection. However, its effect on clinical outcomes in these patients, especially in case of acute type A aortic dissection, has not been clearly elucidated. This study evaluated the influence of the false lumen status, including partial thrombosis, on short-term clinical outcomes in acute type A aortic dissection patients without urgent surgical treatment.
  
  
  METHODS
  Sixty-two patients (29 males, mean age 73±13 years) with acute type A aortic dissection who did not receive urgent surgical treatment at four hospitals were enrolled. Patients were divided into three groups based on the false lumen status on enhanced computed tomography image (complete thrombosis, n=28; partial thrombosis, n=27; patent, n=7). Patients with partial thrombosis were further divided into two groups (thrombus-dominant, n=15; flow-dominant, n=12).
  
  
  RESULTS
  The short-term mortality rate (in-hospital and 30-day) was significantly higher in patients with a patent false lumen, while no significant difference was seen between the other two groups. Patients with flow-dominant partial thrombosis had significantly higher short-term mortality rate than those with thrombus-dominant partial thrombosis (in-hospital, p=0.001 and 30-day, p＜0.001).
  
  
  CONCLUSIONS
  The short-term mortality rate in acute type A aortic dissection patients without urgent surgical treatment was lower in patients with partial thrombosis of the false lumen than in those with a patent false lumen. Furthermore, patients with flow-dominant partial thrombosis had higher mortality rate than those with thrombus-dominant partial thrombosis.
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine.
authors.forename: Akihito
authors.initials: A
authors.lastname: Tanaka
authors.forename: Hideki
authors.initials: H
authors.lastname: Ishii
authors.forename: Susumu
authors.initials: S
authors.lastname: Suzuki
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Ota
authors.forename: Hideki
authors.initials: H
authors.lastname: Oshima
authors.forename: Akihiko
authors.initials: A
authors.lastname: Usui
authors.forename: Kimihiro
authors.initials: K
authors.lastname: Komori
authors.forename: Toyoaki
authors.initials: T
authors.lastname: Murohara
mesh_terms: D000208:Acute Disease; D000368:Aged; D000784:Aortic Dissection / Q000473:pathology / Q000601:surgery*; D001011:Aorta / Q000473:pathology*; D001014:Aortic Aneurysm / Q000473:pathology / Q000601:surgery*; D057510:Endovascular Procedures / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011379:Prognosis; D013927:Thrombosis / Q000209:etiology*