Type A Acute Aortic Dissection: Why Does the False Channel Remain Patent After Surgery?. (April 2014)

• Record Type: Journal Article
• Authors: Bing, Fabrice; Rodière, Mathieu; Martinelli, Thomas; Monnin-Bares, Valérie; Chavanon, Olivier; Bach, Vincent; Baguet, Jean-Philippe; Ferretti, Gilbert R.; Thony, Frédéric
• Is Part Of: Vascular & endovascular surgery. Volume 48:Number 3(2014)
• Page Start: 239
• Page End: 245
• Publication Date: 2014-04
• Subjects: aortic dissection -- intimal tear -- false channel -- CT scanner -- Doppler ultrasound; Blood-vessels -- Surgery -- Periodicals; Blood-vessels -- Endoscopic surgery -- Periodicals; Vascular Surgical Procedures -- Periodicals; Angioplasty -- Periodicals; Surgical Procedures, Minimally Invasive -- Periodicals; Vascular Diseases -- surgery -- Periodicals; Vaisseaux sanguins -- Chirurgie -- Périodiques; Vaisseaux sanguins -- Chirurgie endoscopique -- Périodiques; 617.41
• DOI: 10.1177/1538574413518611
• Languages: English
• ISSNs: 1538-5744

Abstract

Purpose: To understand why the false channel (FC) remains patent after surgery of type A acute aortic dissection (TAAAD). Materials and Methods: Postoperative contrast-enhanced computed tomography scans of 129 patients operated for TAAAD were analyzed, and a color-Doppler ultrasound examination (CDUS) of the supra-aortic vessels (SAVs) was performed in 12 patients. Results: The FC remained patent in 107 (82.9%) patients. The entry site was situated near the distal anastomosis in 43 (40.2%) patients and far from it in 44 (41.1%) patients. In 10 (9.35%) patients, an entry site was observed only in the SAVs. In 10 (9.35%) patients, no entry site was seen. Of the 12 patients explored with CDUS, a retrograde filling of the FC was observed in 11 patients. Conclusion: The frequent postoperative circulating aortic FC can be explained by the persistence of the primary entry tear, the presence of iatrogenic tears, and/or a retrograde filling in the SAVs.