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CLINICAL RESEARCH: AORTIC DISEASES

The Role of False Lumen Size in Prediction of In-Hospital Complications After Acute Type B Aortic Dissection

Chih-Ping Chang, MD^_*, Juhn-Cherng Liu, MD^,, Ying-Ming Liou, PhD, Shih-Sheng Chang, MD^_* and Jan-Yow Chen, MD^_*,,_*

^_* Division of Cardiology, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
Department of Radiology, China Medical University Hospital, Taichung, Taiwan
Department of Life Science, National Chung Hsing University, Taichung, Taiwan
Department of Medical Radiological Technology, China Medical University, Taichung, Taiwan

Manuscript received May 12, 2008; revised manuscript received June 23, 2008, accepted June 24, 2008.

^_* Reprint requests and correspondence: Dr. Jan-Yow Chen, Division of Cardiology, Department of Medicine, China Medical University Hospital, 2 Yuh-Der Road, Taichung 404, Taiwan (Email: janyow{at}ms77.hinet.net).

Objectives: The aim of this study was to determine whether false lumen size predicts in-hospital complications for acute type B aortic dissection.

Background: The incidence of complications developing in patients with acute type B aortic dissection has been high. However, methods for recognizing high-risk patients have not been well-studied. We used quantitative analysis by computed tomography (CT) to predict the occurrence of in-hospital complications.

Methods: Fifty-five consecutive patients with acute type B aortic dissection documented by CT imaging were analyzed. They were divided into groups, with and without in-hospital complications, and compared regarding maximal aortic diameter (MAD), maximal false lumen area (MFLA), minimal true lumen area (MTLA), branch-vessel involvement (BVI), and longitudinal length (LL) of aortic dissection.

Results: There were 31 patients with a stable course (group 1) and 24 patients who developed complications (group 2). The MFLA of group 2 was significantly larger than that of group 1 (group 1 vs. group 2 = 577.7 ± 273.2 mm² vs. 1,899.3 ± 1,642.4 mm², p < 0.001). The BVI number was also higher in group 2 (group 1 vs. group 2 = 1.0 ± 1.1 vs. 3.3 ± 2.0, p < 0.001). On multivariate analysis, only MFLA and BVI number were independent predictors of in-hospital complications. Patients with initial MFLA 922 mm² or BVI number 2 showed a significantly higher incidence of in-hospital complications than the other patients (p < 0.001).

Conclusions: A large MFLA and a higher BVI number are powerful predictors of in-hospital complications after acute type B aortic dissection.

Key Words: acute complications • predictors • type B aortic dissection

Abbreviations and Acronyms   BVI = branch-vessel involvement   CT = computed tomography   LL = longitudinal length   MAD = maximal aortic diameter   MFLA = maximal false lumen area   MTLA = minimal true lumen area

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J. Am. Coll. Cardiol. 2008 52: A31-A32. [Full Text] [PDF]