Subscribe to RSS
DOI: 10.1055/s-0029-1247033
Follow up in patients after repair of acute type-A aortic dissection – clinical results and anatomical findings using MDCT
Objectives: The surgical treatment of type A aortic dissection is usually palliative and most surviving patients remain at considerable risk to develop late postoperative complications; consequently, there is the need for careful long-term follow-up. The present study reports on our experience in the postoperative follow-up of a consecutive series of patients with type A aortic dissection.
Computed tomography (CT) with contrast enhancement provides a convenient, noninvasive method for follow-up of these patients.
Methods: 120 patients after repair of Stanford type A dissection underwent contrast-enhanced 64-row MDCT of the entire aorta (collimation 64×0.625mm; rotation time 0.4sec; 120kV; 300mAs). The aorta and its brancheswas visualized and whether they originated from the true or false lumen were analyzed using source and multiplanar reformation images.
Results: CT demonstrated re-dissection, aneurysmal dilation of the aorta and its branches, and delayed filling of the false lumen. CT also showed persistent patency of the false lumen in many of the postoperative cases.
Conclusions: In type A aortic dissection, operation is only palliative, as the dissection persists: the false lumen is often perfused through one or more communications with the true lumen. Long-term prognosis can be affected by aorta dilation that often (but not always) follows the persistence of wall dissection. For its high reliability MDCT is a very useful method for following up patients operated on for AD and for detecting those who are at higher risk of aortic rupture because of lumen dilation.