Type A Aortic Dissection After Thoracic Endovascular Aortic Repair for Type B

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiology Pub Date : 2024-12-09 DOI:10.1016/j.amjcard.2024.12.005

Kyle A. McCullough MD , Katherine R. Hebeler MD , John B. Eisenga MD , Baron L. Hamman MD , Charles S. Roberts MD

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Abstract

Type A aortic dissection (TAAD) has been associated with thoracic endovascular aortic repair (TEVAR) for aortic conditions: dissection and aneurysm. Our purpose was to study a subset of patients who had an initial TEVAR for type B aortic dissection, followed by a TAAD, which was treated by open ascending aortic repair. Over a 6-year period, 171 consecutive patients underwent open ascending aortic repair for TAAD, of whom 21 (12%) had a previous cardiovascular procedure, 17 of which were endovascular. A total of 9 (5.2%) of 171 patients with TAAD had a previous TEVAR for a type B. The mean interval from TEVAR to open ascending aortic repair for TAAD was 4.6 years, with only 1 occurring within a month. Only 1 patient had abnormal aortic media by histology. In 5 of the 9 patients, the entry tear was in the proximal ascending aorta, remote from the endograft, which suggests that a TAAD late after TEVAR for type B represents a new spontaneous event.

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B型TEVAR术后A型主动脉夹层。

A型主动脉夹层（TAAD）与胸椎血管内主动脉修复（TEVAR）有关，包括主动脉夹层和动脉瘤。我们的目的是研究一组最初因B型主动脉夹层接受TEVAR，随后接受开放性升主动脉修复术治疗的TAAD患者。在6年的时间里，171例TAAD患者连续接受了开放性升主动脉修复术，其中21例（12%）有过心血管手术史，其中17例为血管内手术。171例TAAD患者中有9例（5.2%）既往有b型TEVAR。从TEVAR到TAAD的升主动脉切开修复的平均间隔为4.6年，只有1例发生在一个月内。仅有1例患者经组织学检查发现主动脉介质异常。在9例患者中，5例进入性撕裂位于升主动脉近端，远离移植物，这表明B型TEVAR术后晚期发生TAAD是一种新的自发事件。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Cardiology 医学-心血管系统

CiteScore

4.00

自引率

3.60%

发文量

698

审稿时长

33 days

期刊介绍： Published 24 times a year, The American Journal of Cardiology® is an independent journal designed for cardiovascular disease specialists and internists with a subspecialty in cardiology throughout the world. AJC is an independent, scientific, peer-reviewed journal of original articles that focus on the practical, clinical approach to the diagnosis and treatment of cardiovascular disease. AJC has one of the fastest acceptance to publication times in Cardiology. Features report on systemic hypertension, methodology, drugs, pacing, arrhythmia, preventive cardiology, congestive heart failure, valvular heart disease, congenital heart disease, and cardiomyopathy. Also included are editorials, readers'' comments, and symposia.