Type A acute aortic dissection: why does the false channel remain patent after surgery?

Vasc Endovascular Surg. 2014 Apr;48(3):239-45. doi: 10.1177/1538574413518611. Epub 2014 Jan 14.

Abstract

Purpose: To understand why the false channel (FC) remains patent after surgery of type A acute aortic dissection (TAAAD).

Materials and methods: Postoperative contrast-enhanced computed tomography scans of 129 patients operated for TAAAD were analyzed, and a color-Doppler ultrasound examination (CDUS) of the supra-aortic vessels (SAVs) was performed in 12 patients.

Results: The FC remained patent in 107 (82.9%) patients. The entry site was situated near the distal anastomosis in 43 (40.2%) patients and far from it in 44 (41.1%) patients. In 10 (9.35%) patients, an entry site was observed only in the SAVs. In 10 (9.35%) patients, no entry site was seen. Of the 12 patients explored with CDUS, a retrograde filling of the FC was observed in 11 patients.

Conclusion: The frequent postoperative circulating aortic FC can be explained by the persistence of the primary entry tear, the presence of iatrogenic tears, and/or a retrograde filling in the SAVs.

Keywords: CT scanner; Doppler ultrasound; aortic dissection; false channel; intimal tear.

MeSH terms

  • Acute Disease
  • Aged
  • Aortic Aneurysm / diagnosis
  • Aortic Aneurysm / physiopathology
  • Aortic Aneurysm / surgery*
  • Aortic Dissection / diagnosis
  • Aortic Dissection / physiopathology
  • Aortic Dissection / surgery*
  • Aortography / methods
  • Blood Vessel Prosthesis Implantation* / adverse effects
  • Female
  • Hemodynamics
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / diagnosis
  • Postoperative Complications / physiopathology*
  • Regional Blood Flow
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Ultrasonography, Doppler, Color
  • Vascular Patency*