Aortic Expansion After Acute Type B Aortic Dissection

Aortic Expansion After Acute Type B Aortic Dissection

Author Jonker, Frederik H. W. Google Scholar
Trimarchi, Santi Google Scholar
Rampoldi, Vincenzo Google Scholar
Patel, Himanshu J. Google Scholar
O'Gara, Patrick Google Scholar
Peterson, Mark D. Google Scholar
Fattori, Rossella Google Scholar
Moll, Frans L. Google Scholar
Voehringer, Matthias Google Scholar
Pyeritz, Reed E. Google Scholar
Hutchison, Stuart Google Scholar
Montgomery, Daniel Google Scholar
Isselbacher, Eric M. Google Scholar
Nienaber, Christoph A. Google Scholar
Eagle, Kim A. Google Scholar
Gomes, Walter J. Autor UNIFESP Google Scholar
Int Registry Acute Aortic Google Scholar
Institution Maasstad Hosp Rotterdam
Policlin San Donato IRCCS
Univ Michigan Hlth Syst
Brigham & Womens Hosp
Univ Toronto
S Orsola Univ Hosp
Univ Med Ctr Utrecht
Robert Bosch Krankenhaus
Univ Penn
Univ Calgary
Massachusetts Gen Hosp
Univ Rostock
Universidade Federal de São Paulo (UNIFESP)
Abstract Background. A considerable number of patients with acute type B aortic dissection (ABAD) treated with medical management alone will exhibit aortic enlargement during follow-up, which could lead to aortic aneurysm and rupture. the purpose of this study was to investigate predictors of aortic expansion among ABAD patients enrolled in the International Registry of Acute Aortic Dissection.Methods. We analyzed 191 ABAD patients treated with medical therapy alone enrolled in the registry between 1996 and 2010, with available descending aortic diameter measurements at admission and during follow-up. the annual aortic expansion rate was calculated for all patients, and multivariate regression analysis was used to investigate factors affecting the expansion rate.Results. Aortic expansion was observed in 59% of ABAD patients; mean expansion rate was 1.7 +/- 7 mm/y. in multivariate analysis, white race (regression coefficient [RC], 4.6; 95% confidence interval [CI], 1.4 to 7.7) and an initial aortic diameter less than 4.0 cm (RC, 6.3; 95% CI, 4.0 to 8.6) were associated with increased aortic expansion. Female sex (RC, -3.8; 95% CI, -6.1 to -1.4), intramural hematoma (RC, -3.8; 95% CI, -6.5 to -1.1), and use of calcium-channel blockers (RC, -3.8; 95% CI, -6.2 to -1.3) were associated with decreased aortic expansion.Conclusions. White race and a small initial aortic diameter were associated with increased aortic expansion during follow-up, and decreased aortic expansion was observed among women, patients with intramural hematoma, and those on calcium-channel blockers. These data raise the possibility that the use of calcium-channel blockers after ABAD may reduce the rate of aortic expansion, and therefore further investigation is warranted. (Ann Thorac Surg 2012; 94: 1223-9) (C) 2012 by the Society of Thoracic Surgeons
Language English
Sponsor University of Michigan Health System
Varbedian Fund for Aortic Research
Mardigian Foundation
Gore Medical Inc (Flagstaff, AZ)
Date 2012-10-01
Published in Annals of Thoracic Surgery. New York: Elsevier B.V., v. 94, n. 4, p. 1223-1229, 2012.
ISSN 0003-4975 (Sherpa/Romeo, impact factor)
Publisher Elsevier B.V.
Extent 1223-1229
Origin http://dx.doi.org/10.1016/j.athoracsur.2012.05.040
Access rights Closed access
Type Article
Web of Science ID WOS:000309528300037
URI http://repositorio.unifesp.br/handle/11600/35360

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