Prognosis of Aortic Dissection (Type A) with a Thrombosed False Lumen\CT Findings and Operative Timing\

(Department of Cardiovascular Surgery, Tokyo Metropolitan Hiroo General Hospital, Tokyo, Japan)

Kiyoshi Tamura Hideki Nakahara Hitoshi Furukawa
Several investigators have reported that aortic dissections with thrombosed false lumens has a better prognosis than those with open false lumens. However, the method of treating dissecting aorta with a thrombosed false lumen has not yet been clearly determined. The purpose of the present study is to determine the factors that would indicate surgical treatment for dissecting aorta with thrombosed lumen. Sixteen consecutive cases of type A dissecting aorta with a thrombosed lumen were classified into two groups: event-free group (group R, n=10), recanalization or ulcer-like projection group (group P, n=6). The maximum aortic diameter and thrombosed lumen diameter in group P were significantly greater than in group R (45.00}1.78 vs. 36.00}2.16mm: p=0.0182, 8.00}0.00 vs. 4.00}0.40mm: p=0.0004). In group P, the thrombosed lumen diameter significantly decreased after 1 month. In conclusion, the maximum aortic diameter (45mm), the maximum lumen diameter (8mm), and no decrease of the thrombosed lumen diameter are useful predictors for the risk of recanalization or ulcer-like projection. These cases would require surgical treatment.
@Jpn. J. Cardiovasc. Surg. 31F325-327 (2002)