Anatomic and Operative Predictors of Aortic Expansion Following Aortic Dissection Repair

P0037 

Abstract Submission 

Ryaan EL-Andari (1), Sabin Bozso (1), Nicholas Fialka (1), Michael Moon (1)

(1) University of Alberta, Edmonton, AB

Ryaan EL-Andari    -  Contact Me
University of Alberta

Sabin Bozso    -  Contact Me
University of Alberta

Nicholas Fialka    -  Contact Me
University of Alberta

Michael Moon    -  Contact Me
University of Alberta

Ryaan EL-Andari    -  Contact Me
N/A

Objective: Following acute type A aortic dissection (ATAAD) repair, distal aortic dilation may occur. False lumen (FL) communications at the head vessels and visceral vessels are thought to contribute to this growth. We sought to identify operative and anatomical factors predictive of distal aortic growth following ATAAD repair.
Methods: Patients that underwent ATAAD repair from 2017-2021 were included. This study included 48 patients who underwent ATAAD repair with supra-aortic vessel involvement and at least one year of follow-up imaging. Patients were divided into groups based on surgical repair and dissection type: supraaortic vessel dissection (SAVD), SAVD with head vessel FL communication (SAVD+FL), and those that received hemiarch or extended arch repair. Preoperative and postoperative measurements were taken at zone 1 and at the level of the tracheal bifurcation. Aortic measurements were compared between groups using paired t-tests.
Results: 22 patients received isolated hemiarch repairs, 17 hemiarch with arch stent implantations, and 9 total arch repairs. Measurements of zone 1 did not show significant growth for any group during the follow-up period. Measurements taken at the level of the tracheal bifurcation demonstrated that patients with more false lumen communications at the visceral level experienced a larger degree of distal aortic growth at greater than one year of follow-up.
Conclusions: This study has demonstrated an association of distal aortic expansion with increased visceral FL communications. While extended arch repair may address FL communications at the head vessels, they do not address communications distally. These visceral communications may contribute to distal aortic growth.

Dissection