| ObjectiveUsing imaging technology to explore the severity of DeBakey type I aortic dissection that involved the aortic valve or combined with aortic valve lesion.To investigate the effect of anticoagulation on the remodeling of residual false lumen after aortic valve replacement of DeBakey type I aortic dissection.Materials and MethodsFrom October 2014 to June 2015,a total number of 31 patients with DeBakey type I aortic dissection were retrospectively admitted to our study.Those patients were divided into two groups,group one(n=20)who underwent surgical repairs with total arch replacement and modified stented elephant trunk technique(Sun's Operation)and another group(n=11),who under went surgical repairs with Sun's Operation and aortic valve replacement.CT angiography images about 3 to 6 months after surgery,Imaging data of preoperative and postoperative were compared.The diameter of the true lumen and aorta in the level of the initial,middle and end of the stent,celiac trunk,superior mesenteric artery and renal artery in each phase were measured,and the pre-operation and postoperative ratio of true lumen and aorta were calculated,respectively.In addition,the false lumen thrombosis were also observed.ResultsFrom the image data from the acute DeBakey I aortic dissection,the ratio of the true lumen and aorta diameter before surgery and after surgery in the group that without anticoagulation,as follows:on the level of the initial 0.55±0.13 vs 0.94±0.11?middle of the stent 0.41±0.12 vs 0.86±0.19?end of the stent 0.36±0.14 vs 0.71±0.22?celiac trunk 0.39±0.15 vs 0.46±0.17?superior mesenteric artery 0.45±0.14 vs 0.40±0.14?renal artery 0.45±0.17 vs 0.47±0.14,There was a significant difference in the preoperative ratio of the true lumen and aorta diameter on the level of the initial,middle and end of the stent(P<0.01).There was no significant difference on the level of the celiac trunk,superior mesenteric artery and renal artery(P=0.20?0.21?0.61).The ratio of the true lumen and aorta diameter before surgery in the group that with anticoagulation as follow:on the level of the initial 0.49±0.17 vs 0.81±0.27?middle of the stent 0.41±0.17 vs 0.75±0.20?end of the stent 0.36±0.20 vs 0.62±0.21?celiac trunk 0.43±0.14 vs 0.43±0.21?superior mesenteric artery 0.40±0.14 vs 0.41±0.12?renal artery 0.40±0.16 vs 0.41±0.15,There was a significant difference in the ratio of the true lumen and aorta diameter on the level of the initial,middle and end of the stent(P<0.01).There was no significant difference on the level of the celiac trunk,superior mesenteric artery and renal artery(P= P=0.99?0.75?0.97).On the preoperative image data of the acute DeBakey I aortic dissection,the ratio of the true lumen and aorta diameter between without anticoagulation group and the anticoagulation group as follows:on the level of the initial 0.55±0.13 vs 0.49±0.17?middle of the stent 0.41±0.12 vs 0.41±0.17?end of the stent 0.36±0.14 vs 0.36±0.20?celiac trunk 0.39±0.15 vs 0.43±0.14?superior mesenteric artery 0.41±0.14 vs 0.40±0.14?renal artery 0.45±0.17 vs 0.40±0.16,There are no significant difference between the two groups(p=0.30,0.94,0.96,0.54,0.83,0.49).About 3 to 6 months after surgery,the compare between the two groups,we can get the results as follows:on the level of the initial 0.94±0.11 vs 0.81±0.27?middle of the stent 0.86±0.19 vs 0.75±0.20?end of the stent 0.71±0.22 vs 0.62±0.21?celiac trunk 0.46±0.17 vs 0.43±0.21?superior mesenteric artery 0.45±0.14 vs 0.41±0.12?renal artery 0.47±0.14 vs 0.41±0.15,there was also no significant difference in the ratio of the true lumen and aorta diameter on the 6 levels(p=0.28,0.16,0.28,0.39,0.44,0.23)between the two groups.ConclusionWhether the aortic valve was involved,there has no difference in the lesions of stent and distal aorta.And anticoagulation therapy after aortic valve replacement had also no significant effect on residual false lumen remodeling of DeBakey type I aortic dissection. |
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