title: Predictors of patent false lumen of the aortic arch after hemiarch replacement.
abstract: BACKGROUND
  Hemiarch replacement for acute type A aortic dissection is less invasive than total arch replacement but involves increased risk of late aortic arch dilation because of patent false lumen of the aortic arch. If we can predict this risk, it may be a valuable prognostic indicator for selecting surgical procedures for acute type A aortic dissection.
  
  
  METHODS
  We reviewed our surgical experience to predict patent false lumen. From January 2009 to November 2014, we performed 108 hemiarch replacement procedures for acute type A aortic dissection that had patent false lumen of the ascending aortic arch. We identified 56 patients who had preoperative and postoperative contrast-enhanced computed tomography. Patients' preoperative characteristics, preoperative and postoperative contrast-enhanced computed tomography findings, intraoperative findings and postoperative course were investigated.
  
  
  RESULTS
  Of the 56 patients, 32 (57.1 %) were men and their mean age at surgery was 63.7 ± 11.8 years. Overall in-hospital mortality rate was 7.1 % (4 patients). According to postoperative imaging findings, 56 patients were classified into two groups: group A (39 patients), with patent false lumen, and group B (17 patients), with thrombosed false lumen. Logistic regression analysis revealed that brachiocephalic artery dissection and no tear resection contributed to postoperative patent false lumen of the aortic arch more strongly than did other factors.
  
  
  CONCLUSIONS
  Brachiocephalic artery dissection and no tear resection are potential predictors of patent false lumen of the aortic arch after hemiarch replacement.
authors.affiliation: Cardiovascular Surgery Department, Hiroshima Shimin Hospital, 7-33 Motomachi, Nakaku, Hiroshimashi, Hiroshima Prefecture, Japan. nrd15919@gmail.com.
authors.forename: Gaku
authors.initials: G
authors.lastname: Uchino
authors.affiliation: Cardiovascular Surgery Department, Nagoya Tokushukai General Hospital, Aichi, Japan.
authors.forename: Takeki
authors.initials: T
authors.lastname: Ohashi
authors.affiliation: Cardiovascular Surgery Department, Nagoya Tokushukai General Hospital, Aichi, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Iida
authors.affiliation: Cardiovascular Surgery Department, Nagoya Tokushukai General Hospital, Aichi, Japan.
authors.forename: Masao
authors.initials: M
authors.lastname: Tadakoshi
authors.affiliation: Cardiovascular Surgery Department, Nagoya Tokushukai General Hospital, Aichi, Japan.
authors.forename: Souichirou
authors.initials: S
authors.lastname: Kageyama
authors.affiliation: Cardiovascular Surgery Department, Nagoya Tokushukai General Hospital, Aichi, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Furui
authors.affiliation: Cardiovascular Surgery Department, Nagoya Tokushukai General Hospital, Aichi, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Kodani
mesh_terms: D000784:Aortic Dissection / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging* / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D005260:Female; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D015994:Incidence; D007564:Japan; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology*; D011379:Prognosis; D014057:Tomography, X-Ray Computed
keywords: Hemiarch replacement; Patent false lumen; Total arch replacement; Type A aortic dissection