title: Remnant aortic remodelling in younger patients after acute type I aortic dissection surgery.
abstract: OBJECTIVE
  To study the influence of age on remnant aortic remodelling after acute DeBakey type I aortic dissection (AD) surgery.
  
  
  METHODS
  Between January 1999 and December 2013, 118 acute type I AD patients (26 aged <50 years, Group A; 92 aged  ≥ 50 years, Group B) with either ascending or ascending hemiarch replacement in whom preoperative and >1-month postoperative chest computed tomography (CT) were available were included.
  
  
  RESULTS
  At median CT follow-up of 35.1 (interquartile range, 14.1-65.2) months, the aortic dimensions in Group A increased significantly from the baseline values at the root, arch and descending thoracic aorta levels at 40.8 ± 5.3 mm to 43.1 ± 6.5 mm ( P  = 0.010), 36.8 ± 7.1 mm to 40.7 ± 8.8 mm ( P  = 0.043) and 36.7 ± 6.8 mm to 42.8 ± 11.4 mm ( P  = 0.009), respectively. In Group B, only the descending thoracic aorta had increased significantly from the baseline at 37.8 ± 4.8 mm to 40.7 ± 9.4 mm ( P  = 0.002). Linear regression analysis showed a significant correlation between younger age and aortic size increase, especially at the aortic sinus level. No significant between-group differences in mortality and reoperation rates were seen during the follow-up of 45.0 ± 33.6 months vs 44.1 ± 31.7 months, respectively.
  
  
  CONCLUSIONS
  A significantly greater tendency for the remnant aorta to undergo more rapid and generalized adverse remodelling was seen in younger patients after acute type I AD surgery.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.
authors.forename: Jihoon
authors.initials: J
authors.lastname: Kim
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Hanyang University Guri Hospital, College of Medicine, Hanyang University, Seoul, Korea.
authors.forename: Sun Kyun
authors.initials: SK
authors.lastname: Ro
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.
authors.forename: Joon Bum
authors.initials: JB
authors.lastname: Kim
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.
authors.forename: Sung-Ho
authors.initials: SH
authors.lastname: Jung
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.
authors.forename: Cheol Hyun
authors.initials: CH
authors.lastname: Chung
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.
authors.forename: Jae Won
authors.initials: JW
authors.lastname: Lee
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.
authors.forename: Suk Jung
authors.initials: SJ
authors.lastname: Choo
mesh_terms: D000208:Acute Disease; D000328:Adult; D000784:Aortic Dissection / Q000175:diagnosis / Q000601:surgery*; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D012086:Reoperation; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Aortic dissection; Aortic operation