Jihoon Kim1, Sun Kyun Ro2, Joon Bum Kim1, Sung-Ho Jung1, Cheol Hyun Chung1, Jae Won Lee1, Suk Jung Choo1. 1. Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea. 2. Department of Thoracic and Cardiovascular Surgery, Hanyang University Guri Hospital, College of Medicine, Hanyang University, Seoul, Korea.
Abstract
OBJECTIVES: 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.
OBJECTIVES: 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 ADpatients (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: Ignas B Houben; Theodorus M J van Bakel; Nicholas S Burris; Frans L Moll; Joost A van Herwaarden; Himanshu J Patel Journal: J Card Surg Date: 2020-02-06 Impact factor: 1.620