University thesis:
Dissertation, Albert-Ludwigs-Universität Freiburg i. Br., 2017
Footnote:
cc_by_nc_sa http://creativecommons.org/licenses/by-nc-sa/4.0/deed.de cc
Description:
Abstract: Objectives<br>Acute ascending aortic dissection leads to the ascending aorta diameter increase of over 30%, as previously shown. Changes in aortic geometry after acute descending aortic dissection onset are incompletely understood, as prior imaging is often not available. This study aims to define changes of aortic geometry due to acute Stanford type B dissection.<br><br>Methods<br>Six centers in Germany and Switzerland analysed their acute aortic dissection type B databases, identifying patients who had undergone computed tomography angiography <2 years before aortic dissection onset. Altogether, 25 patients met the study criteria. Aortic geometry (diameter, length and volume) before and after acute type B dissection onset was compared.<br><br>Results<br>Mean age was 60±14 years, and 60% were male. Marfan syndrome and hypertension were present in 20% and 72% of patients, respectively; prior cardiovascular surgery was observed in 24% of patients. The median interval between baseline and type B dissection imaging was 12±10 months. Ascending aorta demonstrated no significant change in aortic area (1115.1±490.1 vs. 1054.8±499.7 cm2, P=0.93) or maximal diameter (38.2±7.7 vs. 38.2±7.6 mm, P=0.91) between pre- and post-dissection imaging. In contrast, proximal descending aorta showed an increase in aortic area (726.9±443.9 vs. 1052.5±503.7 cm2, P=0.01) and maximal diameter (30.8±7.6 vs. 38.4±7.9 mm, P=0.003). Similarly, the volume of descending aorta increased (145.6±108.7 vs. 244.4 ±136.7 cm3, P=0.01) due to dissection onset. <br><br>Conclusion<br>Acute dissection type B significantly increases descending thoracic aorta diameter. Understanding aortic geometrical changes caused by acute dissection may be helpful in planning the stentgraft size if endovascular therapy is necessary