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Post-Surgical Risks Analyzed in Aortic Dissection

False lumen size, higher branch-vessel involvement linked to in-hospital complications

THURSDAY, Sept. 25 (HealthDay News) -- In patients with acute type B aortic dissection, a large maximal false lumen area and a higher branch-vessel involvement greatly increase the risk of in-hospital post-surgical complications, according to research published in the Sept. 30 issue of the Journal of the American College of Cardiology.

Using quantitative analysis by computed tomography, Chih-Ping Chang, M.D., of China Medical University Hospital in Taichung, Taiwan, and colleagues predicted the occurrence of in-hospital complications in 55 eligible patients with acute type B aortic dissection. The investigators analyzed the computed tomography scans comparing the patients with and without in-hospital complications for maximal aortic diameter, maximal false lumen area (MFLA), minimal true lumen area, branch-vessel involvement (BVI), and longitudinal length of aortic dissection.

Only MFLA and BVI number were found to independently predict in-hospital complications, the researchers report. Of the 24 patients who developed complications, the MFLA was larger and the BVI higher than patients with a stable course. Those with initial MFLA of 922 mm2 or greater, or BVI number 2 or greater, had a significantly higher incidence of in-hospital complications, the report indicates.

"More aggressive medical management and early intervention is suggested for those patients in the early phase of type B aortic dissection," the authors conclude.

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