P037. Anatomic and Operative Predictors of Aortic Expansion Following Aortic Dissection Repair
Presented During: POD Abstracts (Available for viewing in the exhibit hall for the duration of the meeting)
Edmonton, AB
Canada - Contact Me
Ryaan EL-Andari is a second year cardiac surgery resident at the University of Alberta in Edmonton, Alberta, Canada. Ryaan obtained his MD from the University of Alberta in 2022 and plans to begin his PhD in Experimental Surgery in July 2024 with a focus on ex situ lung perfusion and lung transplantation.
Thursday, April 25, 2024: 5:38 PM - 7:00 PM
Sheraton Times Square
Room: Central Park
Description
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.
Authors
Ryaan EL-Andari (1), Sabin Bozso (1), Nicholas Fialka (1), Michael Moon (1)
Institutions
(1) University of Alberta, Edmonton, AB
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.
Authors
Ryaan EL-Andari (1), Sabin Bozso (1), Nicholas Fialka (1), Michael Moon (1)
Institutions
(1) University of Alberta, Edmonton, AB
Presentation Duration
PODS will be on display in the exhibit hall for the duration of the meeting during exhibit hall hours. PODS will also be available for viewing on the meeting website. There is no formal presentation associated with your POD, but we encourage you to visit the PODS area during breaks to connect with those viewing.