Predicting late aortic complications after acute type A dissection surgery with volumetric measurements in a Singapore cohort.
10.4103/singaporemedj.SMJ-2021-222
- Author:
Jasmine GE
1
;
Vinay Bahadur PANDAY
2
;
Siew-Pang CHAN
3
;
Bernard WEE
4
;
Julian Chi Leung WONG
1
;
Leok Kheng Kristine TEOH
1
;
Moe Thu SAN
5
;
Carlos A MESTRES
6
;
Theodoros KOFIDIS
1
;
Vitaly A SOROKIN
1
Author Information
1. Department of Cardiac, Thoracic and Vascular Surgery, National University Hospital, Singapore.
2. Department of Medicine, National University Hospital, Singapore.
3. Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
4. Department of Diagnostic Imaging, National University Hospital, Singapore.
5. Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
6. Department of Cardiovascular Surgery, University Hospital Zurich, University of Zurich, Switzerland.
- Publication Type:Journal Article
- Keywords:
Aorta;
aortic dissection;
late complication
- MeSH:
Humans;
Male;
Female;
Retrospective Studies;
Singapore;
Aortic Dissection/diagnostic imaging*;
Middle Aged;
Postoperative Complications/diagnostic imaging*;
Aged;
Tomography, X-Ray Computed;
Aortic Aneurysm/diagnostic imaging*;
Aorta/surgery*;
Adult;
Treatment Outcome;
Computed Tomography Angiography
- From:Singapore medical journal
2025;66(9):469-475
- CountrySingapore
- Language:English
-
Abstract:
INTRODUCTION:This study was conducted to evaluate the efficacy of postoperative computed tomography (CT) measurements of aortic lumen volumes in predicting aortic-related complications following acute type A aortic dissection (ATAAD) repair.
METHODS:We conducted a single-institution retrospective aortic volumetric analysis of patients after ascending aorta replacement performed during 2001-2015. The volumetric measurements of total lumen (total-L), true lumen (TL), false lumen (FL), as well as the TL:FL ratio from the first and second postoperative computer angiograms were obtained. A generalised structural equation model was created to analyse the predictive utility of TL:FL ratio.
RESULTS:One hundred and twenty-five patients underwent surgical intervention, of whom 97 patients were eventually discharged and analysed for postoperative complications. A total of 19 patients were included in the final analysis. Patients with late postoperative aortic complications had a significantly higher FL volume and total-L volume on the first (FL volume P = 0.041, total-L volume P = 0.05) and second (FL volume P = 0.01, total-L volume P = 0.007) postoperative scans. The odds of having aortic complications were raised by 1% with a 1 cm 3 increase in total-L volume and by 2% with a 1 cm 3 increase in FL volume. The TL:FL ratio was significantly lower in patients who developed complications.
CONCLUSION:Postoperative CT volumetric measurements in patients who developed complications are characterised by a significant increase in the FL volume and total-L volume from the first postoperative scans. Patients with disproportionately expanded FL presenting with TL:FL ratios less than 1 were associated with aortic complications. Hence, the TL:FL ratio may be a reliable and useful parameter to monitor postoperative disease progression and to evaluate the risk of late complications in ATAAD patients.
