Fate of distal aorta after acute type A aortic dissection repair: Change and persistency of postoperative false lumen status

Background: The role of false lumen patency related to aortic growth, re-interventions, and post-discharge mortality in the chronic phase of repaired type A acute aortic dissection (TAAAD) remains controversial. We investigated the role of postoperative false lumen patency during long-term follow-up. Methods: Based on postoperative CT images of 70 candidates, 58 eligible patients without alteration of false lumen statuswere assigned into three groups: complete patency, partial patency, and complete thrombosis. Aortic growth of 7 levels was analyzed. Results: Persistent complete patency in post-operative TAAAD presents faster expansion of aortic diameter (95% CI, 0.35 to 11.52; P = 0.038; B = 5.935) and more patients with growth rate > 5 mm/year (P = 0.029). The persistent status of false lumen does not predict post-discharge mortality (P = 0.479). History of coronary artery disease (CAD) is the only independent predictor of post-discharge mortality. Conclusions: In TAAAD patients without change of postoperative false lumen status, completely patent false lumen presents faster aortic growth and more patients with growth rate > 5 mm/year. False lumen status does not correlate with late survival. Here we provide an insight into persistent postoperative false lumen in TAAAD patients and may help cast light on aortic dissection in this specific subgroup to improve their late outcomes. (c) 2018 Elsevier B.V. All rights reserved.