title: Enlargement of aortic arch vessels after surgical repair of type A aortic dissection.
abstract: BACKGROUND
  Information on the growth rate of the diameter of the residual dissected supra-aortic trunk after surgical repair of type A aortic dissection is limited.
  
  
  METHODS
  We retrospectively reviewed 95 consecutive postsurgical patients with type A aortic dissection (acute, 91; chronic, 4) between 2005 and 2016 who were followed up with computed tomography. The diameter of the residual dissected supra-aortic trunk was measured by axial images and multiplanar reformatting, and the growth rate was calculated.
  
  
  RESULTS
  The mean age was 67.2 ± 12.8 years (range, 34-89 years). Forty-one brachiocephalic arteries (43%), 14 left common carotid arteries (15%), and 7 left subclavian arteries (10%) exhibited residual dissection. The diameter of the residual dissected branch with a patent false lumen (FL) gradually increased over time, whereas that with a thrombosed FL decreased and reached a plateau. The growth rate of brachiocephalic, left common carotid, and left subclavian arteries with a patent FL was 1.3 ± 1.2, 0.8 ± 0.3, and 0.6 ± 0.4 mm/y, respectively. One patient required surgical intervention for dilation of the brachiocephalic artery 8 years postoperatively. Multivariate analysis showed that male sex was an independent risk factor for a patent FL in the brachiocephalic artery (P = .0431; odds ratio, 2.04).
  
  
  CONCLUSIONS
  A residual dissected supra-aortic trunk with a thrombosed FL seems to be a benign condition. However, long-term follow-up is necessary for patients with a patent FL of residual dissected supra-aortic trunk, which might occasionally require surgical intervention.
authors.affiliation: Department of Cardiovascular Surgery, KKR Sapporo Medical Center, Sapporo, Japan. Electronic address: yamataka@surg1.med.osaka-u.ac.jp.
authors.forename: Takashi
authors.initials: T
authors.lastname: Yamauchi
authors.affiliation: Department of Cardiovascular Surgery, KKR Sapporo Medical Center, Sapporo, Japan.
authors.forename: Suguru
authors.initials: S
authors.lastname: Kubota
authors.affiliation: Department of Cardiovascular Surgery, KKR Sapporo Medical Center, Sapporo, Japan.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Ohata
authors.affiliation: Department of Cardiovascular Surgery, KKR Sapporo Medical Center, Sapporo, Japan.
authors.forename: Kosei
authors.initials: K
authors.lastname: Hasegawa
authors.affiliation: Department of Cardiovascular Surgery, Chiba Graduate School of Medicine, Chiba City, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Ueda
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000601:surgery*; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods; D016122:Brachiocephalic Trunk / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D002908:Chronic Disease; D000072226:Computed Tomography Angiography; D004108:Dilatation, Pathologic; D005260:Female; D006801:Humans; D007564:Japan; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D015999:Multivariate Analysis; D016017:Odds Ratio; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects*