Aortic Remodeling Following Sun's Procedure for Acute Type A Aortic Dissection

• Published in: Medical science monitor 2017-05, Vol.23, p.2143-2150
• Main Authors: Luo, Jiawen, Fu, Xianming, Zhou, Yangzhao, Tang, Hao, Song, Guobao, Tang, Tao, Liao, Xiaobo, Zhou, Xinmin
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aneurysm, Dissecting - surgery; Aorta - surgery; Aorta, Abdominal - surgery; Aorta, Thoracic - surgery; Aortic Aneurysm, Thoracic; Atrial Remodeling - physiology; Blood Vessel Prosthesis Implantation - methods; Clinical Research; Computed Tomography Angiography - methods; Endovascular Procedures - methods; Female; Humans; Male; Middle Aged; Retrospective Studies; Stents; Thrombosis; Tomography, X-Ray Computed; Treatment Outcome
• ISSN: 1643-3750; 1234-1010; 1643-3750
• DOI: 10.12659/msm.900345

BACKGROUND Sun's procedure is a surgical technique widely used in type A aortic dissection. The purpose of this study was to analyze clinical outcomes and morphologic changes in true and false lumen by computed tomography (CT) angiography after Sun's procedure. MATERIAL AND METHODS We retrospectively reviewed 51 patients who underwent Sun's procedure for acute Stanford type A aortic dissection extending down to iliac bifurcation between January 2013 and December 2014. The images of preoperative, one-month, three-month, and six-month follow-up were analyzed by CT angiography to measure the area and diameter of true and false lumen. RESULTS Four patients died before surgical intervention and postoperative deaths occurred in five patients (in-hospital mortality rate 10.6%). Only 42 patients (36 male, 6 female; mean age, 45.9±9.8 years; range, 24-65 years) with acute type A aortic dissection were involved in our study. Thirty-five patients (83.3%) suffered from chest or abdominal pain and only one patient (2.4%) was asymptomatic. Thirty-seven patients (88.1%) had hypertension as the most common comorbidity. In the ascending aorta, false lumen was eliminated and the change of true lumen was not significant (p>0.05). In the descending aorta, complete and partial thrombosis of false lumen were observed in eight patients (19.0%) and 33 patients (78.6%) by one-month follow-up CT scan, respectively. After the six-month follow-up, the rate of complete thrombosis increased to 36.1% and partial thrombosis decreased to 61.9%. The area and maximal diameter of true lumen were increased significantly (p