Mid-term outcomes of acute type B aortic dissection in Japan single center

Ann Thorac Cardiovasc Surg. 2013;19(6):461-7. doi: 10.5761/atcs.oa.12.02077. Epub 2013 Jan 31.

Abstract

Purpose: To study mid-term outcomes in patients admitted to receive treatment for acute type B aortic dissection.

Methods: The study group comprised 229 patients with acute type B aortic dissection treated between January 2000 and July 2010. 128 patients had a thrombosed false lumen, and 101 had a patent false lumen.

Results: In the thrombosed group, 6 had rupture, 4 had malperfusion, and 118 had no complications. There were 5 early deaths (3.9%). In the patent group, 12 had rupture, 19 had malperfusion, and 70 had no complications. There were 6 early deaths (5.9%). Overall survival rates in the thrombosed group and the patent group were 94.7 ± 2.2% and 90.2 ± 3.2% at 1 year, and 84.3 ± 4.6% and 85.9 ± 4.3% at 5 years (p = 0.892), respectively. Aorta-related event-free rates were 85.6 ± 3.4% and 48.3 ± 5.5% at 1 year, and 76.0 ± 5.1% and 35.2 ± 7.2% at 5 years (p <0.001), respectively.

Conclusions: The incidences of rupture and malperfusion during the acute phase were higher in the patent group compared with the thrombosed group. At the late period, although the aorta-related event rate was higher in the patent group, the survival rate did not differ between two groups. Close follow-up and aggressive intervention strategy of the patent group may result comparable outcomes with the thrombosed group.

MeSH terms

  • Aged
  • Antihypertensive Agents / therapeutic use*
  • Aortic Aneurysm, Thoracic / complications
  • Aortic Aneurysm, Thoracic / therapy*
  • Aortic Dissection / complications
  • Aortic Dissection / therapy*
  • Aortic Rupture / etiology
  • Cohort Studies
  • Endovascular Procedures / methods*
  • Female
  • Humans
  • Japan
  • Male
  • Middle Aged
  • Retrospective Studies
  • Thrombosis
  • Treatment Outcome

Substances

  • Antihypertensive Agents