Statistics Of Aorta Anatomical Data In Patients With Acute Type A Aortic Dissection And Analysis Of Clinical Significance

Propose:The main purpose of this study is to measure the anatomic diameters of aorta in acute type A aortic dissection(TAAD)patients coming to our center,and to provide data support for subsequent interventional treatment of acute type A aortic dissections.At the same time,the data of the location of the tear entry of the acute type A aortic dissection was collected,and the relationship between the location of the tear entry and the clinical features was analyzed。Methods:Patients with Stanford A dissection who had been admitted at our center from 2011 to 2016 with complete imaging data were selected.The clinical data and imaging data of the patients were recorded and grouped according to the surgical method and gender.The patients were followed up for 3 months after operation.The 3-month survival rate was recorded and the relationship between the anatomic diameter of the aorta and the clinic feature was analyzed in Stanford A dissection patients.At the same time,all patients with acute Stanford A dissection who were admitted at our center between 2011 and 2016 were retrospectively analyzed.The demographic characteristics,clinical symptoms,imaging data,surgical information,and clinical outcomes were recorded.The Stanford A dissection patients were then divided into groups to analyze the relationship between the location of the entry tear in the Stanford A dissection patient and the clinical characteristics,as well as the impact on the prognosis.Results:We obtained diameters of the ascending aorta,aortic arch descending aorta at origin location,and diameters of the three branches of the aortic arch,innominate artery,the left common carotid artery,and the left subclavian artery at the opening of the aortic arch.Measurements of descending aorta diameter include the level at the bifurcation of the pulmonary artery and the diaphragm level.Finally,we also measured the length of the aorta of the dissection patient from the left subclavian artery to the seventh thoracic vertebra level.We found that the diameter of the descending aorta at origin level,at the level of the diaphragm and at the bifurcation of the pulmonary artery were lower than that in the female patients.The diameter of the ascending aorta,the age,and the sex ratio were statistically different between the aortic root replacement patients and the aortic dissection patients retaining the roots.Although there were statistical differences between the two groups of patients with cerebrovascular disease,there was no statistical difference in survival between the two groups.The location of entry tear of acute type A aortic dissection was mostly ascending aorta,and the proportion of hypertension in patients with location of entry tear in the aortic arch was significantly higher than that in the ascending aorta and descending aorta group.Compared to patients with entry tear located in the non-ascending aorta,the proportion of cardiac tamponade before operation,poor cerebral perfusion,and aortic regurgitation(>Ⅱ degrees)in patients with entry tear site in ascending aorta is significantly higher.The proportion of male,hypertension,history of cardiac surgery in acute A type aortic dissection patients with entry tear site in aortic arch were higher than those in the non-aortic arch group.However,the incidence of aortic valve regurgitation(>Ⅱ degrees)in the patients was significantly lower than in patients with entry tear site in non-aortic arch.The proportion of male patients,the rate of postoperative renal failure and nerve injury in patients with entry site in descending aorta was higher than that in non-descending aorta.The incidence of aortic valve regurgitation(>Ⅱ degrees)was higher in patients with an acute type A aortic dissection who had entry tear site in non-descending aorta than in patients with entry site located in the descending aorta.Conclusion:The diameter of the aortic root is an influential factor for the operation of the A-type dissection patient’s root.We obtained anatomical data of the aorta in patients with type A aortic dissection and laid the foundation for the design of stent grafts.Patients with acute type A aortic dissection in the ascending aorta have the largest proportion of all patients with acute type A aortic dissection and poor cerebral perfusion and aortic valve regurgitation(>Ⅱ degree)were higher than other patients.Although mortality was no difference between patients with location of entry tear site in ascending aorta and in non-ascending aorta,preoperative diabetes,postoperative pulmonary infections,and thoracotomy after operation may be the risks of postoperative death in patients with entry tear site in the ascending aorta.The proportion of hypertension,the proportion of patients with a history of preoperative cardiac surgery,and the proportion of patients with aortic valve regurgitation(>Ⅱ degrees)in patients with entry tear site in the aortic arch are far higher than those in non-aortic arch.The ratio of renal failure and neurological damage in patients with entry tear site in the descending aorta were higher than other patients,but the proportion of aortic valve regurgitation(>Ⅱ degrees)in patients with entry tear site is less.