Bartosz Rylski1, Camila Muñoz1, Friedhelm Beyersdorf1, Matthias Siepe1, Diana Reser2, Thierry Carrel3, Florian Schoenhoff3, Christian Schlensak4, Mario Lescan4, Hans-Henning Eckstein5, Benedikt Reutersberg5, Raimund Erbel6, Rolf Alexander Janosi7, Martin Czerny1. 1. Department of Cardiovascular Surgery, Heart Center Freiburg University, Faculty of Medicine, University of Freiburg, Freiburg, Germany. 2. Division of Cardiovascular Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland. 3. Department of Cardiovascular Surgery, University Hospital Berne, Berne, Switzerland. 4. Department of Thoracic, Cardiac and Vascular Surgery, University Hospital Tübingen, Tübingen, Germany. 5. Department for Vascular and Endovascular Surgery, Klinikum rechts der Isar, Technical University Munich, Munich, Germany. 6. Institute of Medical Informatics, Biometry and Epidemiology, University Clinic Essen, University Duisburg-Essen, Essen, Germany. 7. Department of Cardiology, West-German Heart and Vascular Center Essen, University Hospital Essen, Essen, Germany.
Abstract
OBJECTIVES: Thoracic endovascular aortic repair is the treatment of choice in complicated acute type B aortic dissection. How to infer predissection aortic diameter is not well understood. Our aim was to delineate changes in descending aortic geometry due to dissection. METHODS: Five tertiary centres reviewed their acute aortic dissection type B databases containing 802 patients. All patients who had undergone computed tomography angiography less than 2 years before and immediately after aortic dissection onset were included. We compared the aortic geometry before and after the dissection onset. RESULTS: Altogether 25 patients were included [median age 60 (first quartile 52, third quartile 72) years; 60% men]. In all except 1 patient, the maximum descending aortic diameter was less than 45 mm before aortic dissection onset. The largest increase in diameter induced by the dissection was observed in the proximal descending aorta 28.2 (25.1, 32.1) vs 34.6 (31.3, 39.1) mm (+6.4 mm; +23%; P < 0.001). The thoracic descending aortic length increased after the dissection onset [253.3 (229.3, 271.9) vs 261.3 (247.9, 285.4) mm; P = 0.003]. The predissection aortic diameter of the proximal thoracic descending aorta was 7.9 (5.2, 10.7) mm larger (P < 0.001) than the post-dissection area-derived true-lumen diameter and 2.5 (1.3, 6.1) mm larger than the maximum true-lumen diameter (P < 0.001). CONCLUSIONS: Type B aortic dissection increases the diameter, length and volume of the descending thoracic aorta. The predissection aortic diameter most closely resembles the post-dissection maximum diameter of the true lumen.
OBJECTIVES: Thoracic endovascular aortic repair is the treatment of choice in complicated acute type B aortic dissection. How to infer predissection aortic diameter is not well understood. Our aim was to delineate changes in descending aortic geometry due to dissection. METHODS: Five tertiary centres reviewed their acute aortic dissection type B databases containing 802 patients. All patients who had undergone computed tomography angiography less than 2 years before and immediately after aortic dissection onset were included. We compared the aortic geometry before and after the dissection onset. RESULTS: Altogether 25 patients were included [median age 60 (first quartile 52, third quartile 72) years; 60% men]. In all except 1 patient, the maximum descending aortic diameter was less than 45 mm before aortic dissection onset. The largest increase in diameter induced by the dissection was observed in the proximal descending aorta 28.2 (25.1, 32.1) vs 34.6 (31.3, 39.1) mm (+6.4 mm; +23%; P < 0.001). The thoracic descending aortic length increased after the dissection onset [253.3 (229.3, 271.9) vs 261.3 (247.9, 285.4) mm; P = 0.003]. The predissection aortic diameter of the proximal thoracic descending aorta was 7.9 (5.2, 10.7) mm larger (P < 0.001) than the post-dissection area-derived true-lumen diameter and 2.5 (1.3, 6.1) mm larger than the maximum true-lumen diameter (P < 0.001). CONCLUSIONS: Type B aortic dissection increases the diameter, length and volume of the descending thoracic aorta. The predissection aortic diameter most closely resembles the post-dissection maximum diameter of the true lumen.
Authors: Maximilian Kreibich; Bartosz Rylski; Stoyan Kondov; Julia Morlock; Johannes Scheumann; Fabian A Kari; Holger Schröfel; Matthias Siepe; Friedhelm Beyersdorf; Martin Czerny Journal: J Vis Surg Date: 2018-04-04
Authors: Norman A Orabi; Leslie E Quint; Kuanwong Watcharotone; Bin Nan; David M Williams; Karen M Kim Journal: Int J Cardiovasc Imaging Date: 2018-06-18 Impact factor: 2.357
Authors: Maximilian Kreibich; Tim Berger; Tim Walter; Paul Potratz; Philipp Discher; Stoyan Kondov; Friedhelm Beyersdorf; Matthias Siepe; Roman Gottardi; Martin Czerny; Bartosz Rylski Journal: Cardiovasc Diagn Ther Date: 2022-06
Authors: Tim Walter; Tim Berger; Stoyan Kondov; Roman Gottardi; Julia Benk; Bartosz Rylski; Martin Czerny; Maximilian Kreibich Journal: Front Cardiovasc Med Date: 2022-06-30