Significance of distal false lumen after type A dissection repair

Diretrizes para a cirurgia das doenças da aorta

“…Entretanto, essa patência não deve ser entendida como iminência de eventos catastróficos; muitas vezes ela pode ser a principal fonte de suprimento sanguíneo de alguns órgãos nobres 98 . Na experiência do Mount Sinai Medical Center 103 , a persistência da falsa luz esteve associada à baixa incidência de degeneração aneurismática, e nenhuma diferença significativa na sobrevida tardia: dois de 18 casos de falsa luz patente necessitaram intervenção (11%), e a curva de sobrevida livre de eventos em 5 anos foi de 83% para falsa luz trombosada, e de 64% em casos com falsa luz patente (p=NS).…”

Prognosis of Retrograde Dissection From the Descending to the Ascending Aorta

“…Similarly, it has been reported that a patent false lumen correlates closely with variant late complications, including aneurysmal dilatation of the distal aorta, reoperation and aortic rupture. 19,20 Recent advances in surgical techniques have led to successful one-stage repair of the entire dissected aorta in the acute phase. 5,10,11,19 However, even when the latest surgical techniques are used, the operative mortality rate for simultaneous aortic arch replacement generally ranges from 13% to 46%, and the postoperative morbidity rate is extremely high.…”

“…19,20 Recent advances in surgical techniques have led to successful one-stage repair of the entire dissected aorta in the acute phase. 5,10,11,19 However, even when the latest surgical techniques are used, the operative mortality rate for simultaneous aortic arch replacement generally ranges from 13% to 46%, and the postoperative morbidity rate is extremely high. 10,11 In addition, access to the descending thoracic aorta distal to the left subclavian artery by median sternotomy is a problem and the surgical approach selected for repair of the ascending aorta and aortic arch is different from that for repair of a thoracoabdominal lesion.…”

Extensive Primary Repair of the Thoracic Aorta in Acute Type A Aortic Dissection by Means of Ascending Aorta Replacement Combined With Open Placement of Triple-Branched Stent Graft

“…3,4 When continuous enlargement of the residual dissection occurs, the chances of survival might remain uncertain, and reoperation is usually inevitable. [3][4][5][6] Therefore, for patients with acute type A aortic dissection who are predicted to have enlargement of residual dissection after conventional ascending replacement such as patients who are Ͻ55 years of age, those with Marfan syndrome, or those who have intimal tear in the arch or proximal descending aorta, extensive primary repair of the thoracic aorta is desirable if it can be performed safely. 4,6 Clinical Perspective on p 1378…”