Predictors for outcome in type A aortic dissection. a focus on false lumen

Background: Acute type A aortic dissection (AAD) is a life-threatening emergency in cardiac surgery, with high in-hospital (22%) and long-term morbidity and mortality rates. Methods: Data from 134 patients were collected from anamnesis and computed tomography before and after aortic surgery. Data were analyzed using IBM SPSS v23. Results: We found that male patients had better survival than the female (p < 0.01) and that age is associated with increased perioperative death (p < 0.001). Similarly, patients admitted in shock (p < 0.001) and undergoing longer extracorporeal circulation (p < 0.05) were associated with lower survival. We observed that patients admitted with partial thrombosis of false lumen had increased survival compared to those presenting a patent lumen (p < 0.001). Also, we compared the mortality of the different surgical procedures and found that no intervention had a significant association with increased survival (p > 0.05). Among survived patients, we found that an increased pre-operative ascending aorta diameter is associated with the establishment of a chronic partial thrombosis (54.2 ± 4.6 vs 50.5 ± 7.0 mm, p < 0.05). Moreover, increased pre-operative descending aorta diameter is associated with a longer complete thrombosis time (29.2 ± 6.1 vs 37.2 ± 6.9 mm, p < 0.05). Conclusions: We found that, in our experience, there is no significant difference between the most commonly used surgical procedures. However, we found that age, gender, shock, pre-operative lumen patency and CEC time are important predictors of survival. Moreover, we found that pre-operative aortic diameters are dramatically relevant to determine the time for a complete thrombosis of the false lumen.