title: Do early postoperative CT findings following type A aortic dissection repair predict early clinical outcome?
abstract: OBJECTIVE
  The purposes of this study are to determine the prevalence of specific postoperative CT findings following Stanford type A aortic dissection repair in the early postoperative period and to determine if these postoperative findings are predictive of adverse clinical outcome.
  
  
  METHODS
  Patients who underwent type A dissection repair between January 2012 and December 2014 were identified from our institutional cardiac surgery database. Postoperative CT exams within 1 month of surgery were retrospectively reviewed to determine sizes and attenuation of mediastinal, pericardial, and pleural fluid, and the presence or absence of pneumomediastinum, pneumothorax, or lung consolidation. Poor early clinical outcome was defined as length of stay (LOS) > 14 days. Student's t test and chi-square test were used to determine the relationship between postoperative CT features and early clinical outcome.
  
  
  RESULTS
  Thirty-nine patients (24 M, 15 F, mean age 58.5 ± 13.7 years) underwent type A dissection repair and mean LOS was 17.3 ± 21.2 days. A subset of 19 patients underwent postoperative CTs within 30 days of surgery, and there was no significant relationship between LOS and sizes and attenuation of mediastinal, pericardial, and pleural fluid, and the presence or absence of pneumomediastinum, pneumothorax, or lung consolidation.
  
  
  CONCLUSIONS
  CT features such as mediastinal, pericardial, and pleural fluid were ubiquitous in the early postoperative period. There was no consistent CT feature or threshold that could reliably differentiate between "normal postoperative findings" and early postoperative complications.
authors.affiliation: The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, 600 North Wolfe Street, Hal B168, Baltimore, MD, 21287, USA. lindachu@jhmi.edu.
authors.forename: Linda C
authors.initials: LC
authors.lastname: Chu
authors.affiliation: Division of Cardiac Surgery, Johns Hopkins University, 600 North Wolfe Street, Baltimore, MD, 21287, USA.|Division of Cardiac Surgery, University of British Columbia, 494 - 1801 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
authors.forename: Joel
authors.initials: J
authors.lastname: Price
authors.affiliation: Division of Cardiac Surgery, Johns Hopkins University, 600 North Wolfe Street, Baltimore, MD, 21287, USA.
authors.forename: Allen
authors.initials: A
authors.lastname: Young
authors.affiliation: Division of Cardiac Surgery, Johns Hopkins University, 600 North Wolfe Street, Baltimore, MD, 21287, USA.
authors.forename: Duke E
authors.initials: DE
authors.lastname: Cameron
authors.affiliation: The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, 600 North Wolfe Street, Hal B168, Baltimore, MD, 21287, USA.
authors.forename: Elliot K
authors.initials: EK
authors.lastname: Fishman
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Aortic dissection; Aortic root replacement; CT; Postoperative complications