Extent of preoperative false lumen thrombosis does not influence long-term survival in patients with acute type A aortic dissection.

Partial thrombosis of the false lumen has been related to aortic growth,reoperations,and death in the chronic phase of type b and repaired type a aortic dissections. the impact of preoperative false lumen thrombosis has not been studied previously. we used data from a contemporary,multinational database on aortic dissections to evaluate whether different degrees of preoperative false lumen thrombosis influenced long-term prognosis. we examined the records of 522 patients with surgically treated acute type a aortic dissections who survived to discharge between 1996 and 2011. at the preoperative imaging,414 (79.3%) patients had patent false lumens,84 (16.1%) had partial thrombosis of the false lumen,and 24 (4.6%) had complete thrombosis of the false lumen. the annual median (interquartile range) aortic growth rates were 0.5 (-0.3 to 2.0) mm in the aortic arch,2.0 (0.2 to 4.0) mm in the descending thoracic aorta,and similar regardless of the degree of false lumen thrombosis. the overall 5-year survival rate was 84.7%,and it was not influenced by false lumen thrombosis (p=0.86 by the log-rank test). independent predictors of long-term mortality were age >70 years (hazard ratio [hr],2.34; 95% confidence interval [ci],1.20 to 4.56,p=0.012) and postoperative cerebrovascular accident,coma,and/or renal failure (hr,2.62; 95% ci,1.40 to 4.92,p=0.003). patients with acute type a aortic dissection who survive to discharge have a favorable prognosis. preoperative false lumen thrombosis does not influence long-term mortality,reintervention rates,or aortic growth.