초록접수 현황
| 14F-272 | 구연 발표 |
Remodeling of the Remnant Aorta after Acute Type A Aortic Dissection Surgery; Are Young Patients More Likely to Develop Adverse Aortic Remodeling of the Remnant Aorta Over Time?
김지훈¹, 주석중¹, 노선균², 김준범¹, 정성호¹, 정철현¹, 이재원¹
울산대학교 의과대학 서울아산병원 흉부외과학교실¹, 한양대학교 의과대학 한양대구리병원 흉부외과학교실²
Background : Adverse aortic remodeling after acute type A aortic dissection in younger ages may be more aggressive in its course than in advanced age. To investigate this assumption, dimensions of the remnant aorta were analyzed over time after ascending/hemiarch aortic replacement for acute type A aortic dissection.
Methods : From January 1999 to December 2013, 190 patients had undergone ascending and/or hemiarch aortic replacement for acute type A aortic dissection. Pre- and post-operative chest computed tomography (CT) were performed in 162 patients and of these, 124 patients (76.5%) in whom follow up lasted longer than one month were enrolled. The diameter of the remnant aorta at the aortic sinus, arch and the descending thoracic aorta level were measured using chest CT.
Results : The patients were divided into two groups; group A (age < 50 years, n=29) and group B (age ≥ 50 years, n=95). Overall median CT follow up was 1091.5 (IQR 427.8 – 1982.3) days. In group A, the pre-operative and last follow up diameter at the sinus level were 41.8 ± 6.0 mm and 44.1 ± 7.3 mm, respectively (p=0.004). The dimensions at the aortic arch level were 36.5 ± 6.8 mm and 41.3 ± 8.6 mm (p=0.010) and at the descending thoracic aorta level they were 36.4 ± 6.6 mm to 43.0 ± 11.2 mm (p=0.003). In group B, only the descending thoracic aorta showed significant increases over time (37.6 ± 4.8 mm to 40.6 ± 9.3, p=0.002), while the aortic sinus and the aortic arch did not appear to significantly change.
Conclusion : All segments of the non-operated remnant aorta in young patients showed significant dilatation over time after acute type A aortic dissection surgery whereas in the older patients only the descending thoracic aorta appeared to significantly dilate. The results suggested a more extensive pattern of aortic remodeling in relatively younger patients.
Methods : From January 1999 to December 2013, 190 patients had undergone ascending and/or hemiarch aortic replacement for acute type A aortic dissection. Pre- and post-operative chest computed tomography (CT) were performed in 162 patients and of these, 124 patients (76.5%) in whom follow up lasted longer than one month were enrolled. The diameter of the remnant aorta at the aortic sinus, arch and the descending thoracic aorta level were measured using chest CT.
Results : The patients were divided into two groups; group A (age < 50 years, n=29) and group B (age ≥ 50 years, n=95). Overall median CT follow up was 1091.5 (IQR 427.8 – 1982.3) days. In group A, the pre-operative and last follow up diameter at the sinus level were 41.8 ± 6.0 mm and 44.1 ± 7.3 mm, respectively (p=0.004). The dimensions at the aortic arch level were 36.5 ± 6.8 mm and 41.3 ± 8.6 mm (p=0.010) and at the descending thoracic aorta level they were 36.4 ± 6.6 mm to 43.0 ± 11.2 mm (p=0.003). In group B, only the descending thoracic aorta showed significant increases over time (37.6 ± 4.8 mm to 40.6 ± 9.3, p=0.002), while the aortic sinus and the aortic arch did not appear to significantly change.
Conclusion : All segments of the non-operated remnant aorta in young patients showed significant dilatation over time after acute type A aortic dissection surgery whereas in the older patients only the descending thoracic aorta appeared to significantly dilate. The results suggested a more extensive pattern of aortic remodeling in relatively younger patients.
책임저자: 주석중
울산대학교 의과대학 서울아산병원 흉부외과학교실
연락처 : 김지훈, Tel: 02-3010-3580 , E-mail : jihoonkim.md@gmail.com
