Abstract 4529: Partial Thrombosis of the False Lumen is Not a Predictor of Follow-up Mortality in Patients With Acute Type A Aortic Dissection
Background: Prophylactic interventions in patients with chronic aortic dissections are based on serial control images of the aortic wall. Previous assessments in patients with type B dissections have indicated that a partially thrombosed false lumen is an independent predictor of intermediate and/or long term mortality. In the present study, we assessed the hypothesis that a partially thrombosed false lumen also is a predictor of increased mortality in patients with acute type A dissections.
Methods: The International Registry of Acute Aortic Dissection (IRAD) is a large database containing patients from 24 hospitals world-wide. Patients with acute type A aortic dissection with registered follow-up data (n=379) were divided into three groups according to the status of the dissected aortic wall (patent flow in the false lumen, n=281 (74.1%), complete thrombosis of the false lumen, n=32 (8.4%), partial thrombosis of the false lumen, n=66 (17.4%). In these three groups follow-up mortality was compared using Kaplan-Meier survival analysis and log rank tests.
Results: The mean follow-up for these patients was 1064 days (+/− 662). We did not observe any difference in survival according to the status of the false lumen in the aortic wall (log rank test p=0.86 in patients with patent false lumen, p=0.28 in thrombosed and p=0.59 in partially thrombosed false lumen).
Conclusion: Status of the false lumen does not seem to influence mortality in patients with type A dissection admitted to an IRAD center follow-up program. Risk factors for death in the follow up period after aortic dissection need further characterization and analysis of their prognostic value.