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

研究成果: Article査読

抄録

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.

本文言語English
ページ(範囲)1132-1140
ページ数9
ジャーナルInteractive cardiovascular and thoracic surgery
34
6
DOI
出版ステータスPublished - 2022 6月 1

ASJC Scopus subject areas

  • 外科
  • 呼吸器内科
  • 循環器および心血管医学

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