Evaluation and Influence of Brachiocephalic Branch Re-entry in Patients With Type A Acute Aortic Dissection
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- Yasuda Shota
- Cardiovascular Center, Yokohama City University Medical Center
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- Imoto Kiyotaka
- Cardiovascular Center, Yokohama City University Medical Center
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- Uchida Keiji
- Cardiovascular Center, Yokohama City University Medical Center
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- Karube Norihisa
- Cardiovascular Center, Yokohama City University Medical Center
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- Minami Tomoyuki
- Cardiovascular Center, Yokohama City University Medical Center
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- Goda Motohiko
- Department of Surgery, Yokohama City University
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- Suzuki Shinichi
- Department of Surgery, Yokohama City University
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- Masuda Munetaka
- Department of Surgery, Yokohama City University
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Abstract
<p>Background:Stanford type A acute aortic dissection (A-AAD) extends to the brachiocephalic branches in some patients. After ascending aortic replacement, a remaining re-entry tear in the distal brachiocephalic branches may act as an entry and result in a patent false lumen in the aortic arch. However, the effect of brachiocephalic branch re-entry concomitant with A-AAD remains unknown.</p><p>Methods and Results:Eighty-five patients with A-AAD who underwent ascending aortic replacement in which both preoperative and postoperative multiple-detector computed tomography (MDCT) scans could be evaluated were retrospectively studied. The presence of a patent false lumen in at least one of the brachiocephalic branches on preoperative MDCT was defined as brachiocephalic branch re-entry, and 41 patients (48%) had this. Postoperatively, 47 of 85 (55%) patients had a patent false lumen in the aortic arch. False lumen remained patent after operation in 34 out of the 41 (83%) patients with brachiocephalic branch re-entry, as compared to that in 13 of the 44 (30%) patients without such re-entry (P<0.001). Brachiocephalic branch re-entry was a significant risk factor for a late increase in the aortic arch diameter greater than 10 mm (P=0.047).</p><p>Conclusions:Brachiocephalic branch re-entry in patients with A-AAD is related to a patent false lumen in the aortic arch early after ascending aortic replacement and is a risk factor for late aortic arch enlargement.</p>
Journal
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- Circulation Journal
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Circulation Journal 81 (1), 30-35, 2017
The Japanese Circulation Society
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Details 詳細情報について
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- CRID
- 1390001205107917440
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- NII Article ID
- 130005252653
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- NII Book ID
- AA11591968
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- ISSN
- 13474820
- 13469843
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- NDL BIB ID
- 027807936
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- PubMed
- 27885195
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- Text Lang
- en
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- Data Source
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- JaLC
- NDL
- Crossref
- PubMed
- CiNii Articles
- KAKEN
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- Abstract License Flag
- Disallowed