Early Diagnosis of Acute Aortic Dissection Associated with Aortic Root Lesions by Contrast-Enhanced CT Scanning.
10.4326/jjcvs.25.279
- VernacularTitle:急性大動脈解離に伴う大動脈基部病変の造影CTによる早期診断
- Author:
Tadanori Kawada
;
Shigeki Hunaki
;
Satoshi Kamata
;
Teruyuki Koyama
;
Shigeki Miyamoto
;
Keita Kikuchi
;
Yousuke Kitanaka
;
Kanako Kimura
;
Hiroshi Takei
;
Noboru Yamate
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
1996;25(5):279-284
- CountryJapan
- Language:Japanese
-
Abstract:
The earlier the diagnosis of acute type A aortic dissection is made, the more frequent the complications of aortic root destruction and/or a compromised coronary artery are encountered. Only aortography is diagnostic in these lesions, however, recently this modality tends to be avoided in order to try to improve the survival rate of the patients by obtaining diagnosis by noninvasive modalities. Therefore, contrast-enhanced CT scans in 49 patients with aortic dissection were analyzed in order to detect the slightest signs suggesting aortic root lesions. In 4 of the 6 cases in which intimal flap was detected in the aortic root by CT and in 2 of the 14 cases with an aortic root more than 35mm in diameter, aortic root reconstruction and/or concomitant CABG were neccessary for the repair of the destroyed aortic root. The aortic root diameter was more than 40mm in 8 of 9 patients with aortic root destruction, with a mean value of 45.6±3.6mm (p<0.01). In summary, detection of a septum in the aortic root and/or an aortic root dilated more than 40mm on CT were important signs suggesting the dissection extending to the aortic sinus combined with aortic root destruction. In such cases aortic root reconstruction and/or concomitant CABG may be necessary.