Imaging surveillance for complications after primary surgery for type A aortic dissection

Abstract

Acute type A aortic dissection (ATAAD) is a life-threatening condition that requires emergency surgery to avert fatal outcome. Conventional surgical procedures comprise excision of the entry tear and replacement of the proximal aorta with a synthetic vascular graft. In patients with DeBakey type I dissection, this approach leaves a chronically dissected distal aorta, putting them at risk for progressive dilatation, dissection propagation and aortic rupture. Therefore, ATAAD survivors should undergo serial imaging for evaluation of the aortic valve, proximal and distal anastomoses, and the aortic segments beyond the distal anastomosis. The current narrative review aims to describe potential complications in the early and late phases after ATAAD surgery, with focus on their specific imaging findings.

Aortic dissection

“…Follow-up with CT or ECG at regular intervals for life, along with strict lifelong BP management, usually with β-blockers, is indicated for patients treated for AAS. 14…”

Heartbeat: hospitalisation for COVID-19 is associated with an increased risk of subsequent adverse cardiovascular events

“…Clinicians caring for patients after an aortic dissection will find the review article by Heuts and colleagues9 a useful practical guide. Early postoperative complications include anastomotic leak, pseudoaneurysm and distal malperfusion, If the native aortic sinuses were not replaced at time of aortic dissection due to surgical urgency or risk, long term complications include dilation and dissection of the native aortic sinuses and associated aortic valve regurgitation.…”