False lumen being larger than true lumen is associated with late aortic events in uncomplicated type B aortic dissection

Akihito Matsushita, Minoru Tabata, Takashi Hattori, Wahei Mihara, Yasunori Sato

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVES: In uncomplicated type B aortic dissection, a large false lumen (FL) is reportedly a risk factor for late aortic events. However, it is unclear how the relationship between the false and true lumen (TL) diameters affects the dissected aorta. This study aimed to evaluate the impact on clinical outcomes of the FL being larger than the TL. METHODS: We retrospectively reviewed 111 consecutive patients with uncomplicated acute type B aortic dissection between 2004 and 2018. We divided the patients into group A (FL > TL; n = 51) and group B (FL ≤ TL; n = 60), and compared the outcomes. The endpoints were aortic events, including surgery for aortic dissection and indication for surgery, and mortality. RESULTS: The 5-year incidence rates of aortic events were 68.4% in Group A and 33.6% in Group B (P = 0.002). The 5-year all-cause mortality rates were 5.3% in Group A and 21.9% in Group B (P = 0.003). The multivariable analyses revealed that FL > TL was an independent factor associated with aortic events (adjusted hazard ratio 2.482, 95% confidence interval 1.467-4.198, P < 0.001), but had low mortality (adjusted hazard ratio 0.209, 95% confidence interval 0.073-0.597, P = 0.003). CONCLUSIONS: Patients with uncomplicated type B aortic dissection with FL > TL at admission are at increased risk of aortic events but improve mortality compared to patients with FL ≤ TL. CLINICAL TRIAL REGISTRATION: UMIN000036997.

Original languageEnglish
Pages (from-to)1132-1140
Number of pages9
JournalInteractive cardiovascular and thoracic surgery
Volume34
Issue number6
DOIs
Publication statusPublished - 2022 Jun 1

Keywords

  • Uncomplicated Stanford type B Aortic dissection

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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