Fate of the false lumen following surgical repair of aortic dissections: an angiographic study.

Postoperative angiography was performed in 27 patients who had surgical repair for aortic dissections. The ascending aorta was involved in 22 dissections (Type A), while in five dissections it was uninvolved (Type B). Findings were assessed between two weeks and 13 years postoperatively. Despite the primary surgical objective to abolish flow in the false lumen, the majority of patients, whether symptomatic or not, continued to harbor patent distal false channels. In certain cases, one or more vital aortic branches were perfused solely by the false lumen. Initial postoperative angiography is indicated for determined surgical results as well as the functional significance of late angiographic findings, should symptoms recur. Further extension of the initial dissection, redissection, or enlargement of localized saccular aneurysms may mandate late reoperation. These conditions manifest themselves by pain, aortic regurgitation, neurological sequelae, or compromise of blood flow to a vital organ or extremity.