Enlargement of aortic arch vessels after surgical repair of type A aortic dissection

Abstract

A residual dissected supra-aortic trunk with a thrombosed FL seems to be a benign condition. However, long-term follow-up is necessary for patients with a patent FL of residual dissected supra-aortic trunk, which might occasionally require surgical intervention.

Long-term fate of aortic branches in patients with aortic dissection

“…The incidence, mechanism, and clinical impact of aortic branches complications in patients with acute AD are already well-described 1,2,6 .However, only a few studies focused on the long-term behavior of non-aortic arterial segments, mainly focusing on supra-aortic arch vessels 11,12 or Marfan patients 13,14 , and the general morbidity and mortality derived from aortic branchesrelated events during the long-term follow-up are still incompletely defined.…”

“…Only scarce information is available regarding the diameter change of non-aortic segments in patients with AD. Yamauchi et al 12 described an overall 1mm/year diameter increase for supraaortic arch arteries in patients with a previous type A dissection; they also found that patency of the false lumen of a dissected branch was associated with diameter increase. Yetman et al 14 highlighted that one third of adult patients with Marfan syndrome develop peripheral artery aneurysms, especially in case of distal aortic dissection or in patients not receiving Angiotensinconverting enzyme inhibitors.…”

Natural history of aneurysmal aortic arch branch vessels in a single tertiary referral center

“…Using 0.04 cm/y, it would take 25 years for a 2.0-cm innominate artery aneurysm to reach the 3.0-cm recommended surgical threshold proposed by Kieffer et al 12 Our aneurysmal AABVs were nondissected vessels, other than one left subclavian artery true aneurysm. Yamauchi et al 31 found that dissected innominate and left common carotid arteries grew at faster rates with a patent false lumen than with a thrombosed false lumen. Because of the benign behavior we observed in terms of rupture and growth, we recommend observation for these aneurysms.…”