False Lumen Status in Patients With Acute Aortic Dissection: A Systematic Review and Meta-Analysis

Background: the long-term association between the status of the false lumen and poor patient outcomes in acute aortic dissection (aad) remains unclear. this systematic review and meta-analysis investigated whether the status of the false lumen was a predictor of poor long-term survival in aad. methods and results: eleven cohort studies (2924 participants) exploring the association between the false lumen status and long-term outcomes (>1 year) in aad were included. all studies reported multivariate-adjusted hazard ratios (hrs) with 95% cis for long-term outcomes,according to false lumen status. pooled hrs for mortality and aortic events were computed and weighted using generic inverse-variance and random-effect modeling. residual patent false lumen was an independent predictor of long-term mortality in aad type a (hr,1.71; 95% ci,1.16-2.52; p=0.007) and type b (hr,2.79; 95% ci,1.80-4.32; p<0.001). aad patients with residual patent false lumen exhibited an increased risk of aortic events (hr,5.43; 95% ci,2.95-9.99; p<0.001). partial false lumen thrombosis was independently associated with long-term mortality in type b aad (hr,2.24; 95% ci,1.37-3.65; p=0.001). this association was not observed in aad type a patients (hr,1.75; 95% ci,0.88-3.45; p=0.211). conclusions: the false lumen status influences late outcomes in aad. residual patent false lumen is independently associated with poor long-term survival in aad. however,only type b aad patients with partial false lumen thrombosis had an increased late mortality risk. © 2016 the authors. published on behalf of the american heart association,inc.,by wiley blackwell.