JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES) ›› 2016, Vol. 54 ›› Issue (12): 27-31.doi: 10.6040/j.issn.1671-7554.0.2016.871

Previous Articles     Next Articles

Effect of anticoagulation on the remodeling of residual false lumen after aortic valve replacement of DeBakey type I aortic dissection

WANG Long1, ZHAO Xin1, LI Yuanyuan2, WANG Ximing2, LI Decai3, SONG Guangmin1   

  1. 1. Department of Cardiovascualar Surgery, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China;
    2. Shandong Medical Imaging Research Institute, Jinan 250021, Shandong, China;
    3. Department of Cardiovascualar Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong, China
  • Received:2016-07-20 Online:2016-12-10 Published:2016-12-10

Abstract: Objective To investigate the effect of anticoagulation on the remodeling of residual false lumen after aortic valve replacement of DeBakey type I aortic dissection. Methods Clinical data of 31 patients with DeBakey type I aortic dissection treated during Oct. 2014 and Jun. 2015 were retrospectively analyzed. The patients were divided into two groups, that is, group one(n=20)who underwent surgical repairs with total arch replacement and modified stented elephant trunk technique(Suns Operation), and group two(n=11)who underwent surgical repairs with Suns Operation and aortic valve replacement. About 3 to 6 months after surgery, aortic CT angiography was performed to measure 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. The pre-operation and postoperative ratios of true lumen and aorta were 山 东 大 学 学 报 (医 学 版)54卷12期 -王龙,等.主动脉瓣置换术后抗凝对DeBakeyⅠ型主动脉夹层残余假腔重塑效果的临床影响 \=-calculated, respec-tively. In addition, the false lumen thrombosis was observed. Results There was no significant difference in the preoperative ratio of the true lumen and aorta diameter in the levels of the initial, middle and end of the stent, celiac trunk, superior mesenteric artery and renal artery(P=0.30, 0.94, 0.96, 0.54, 0.83, 0.49)between the two groups. After surgery, there was no significant difference in the ratio of the true lumen and aorta diameter in the 6 levels(P=0.28, 0.16, 0.28, 0.39, 0.44, 0.23)between the two groups. Conclusion Whether the aortic valve is involved has no difference in the lesions of stent and distal aorta. Anticoagulation therapy after aortic valve replacement has no significant effect on the residual false lumen remodeling of DeBakey type I aortic dissection.

Key words: DeBakey type I, Anticoagulation, Residual false lumen, Aortic dissection

CLC Number: 

  • R654.2
[1] Tanaka A, Sandhu HK, Estrera AL, et al. Descending endografts for type A dissections: con[J]. Ann Cardiothorac Surg, 2016, 5(3):227-232.
[2] Conzelmann LO, Weigang E, Mehlhorn U, et al. Mortality in patients with acute aortic dissection type A: analysis of pre- and intraoperative risk factors from the German Registry for Acute Aortic Dissection Type A(GERAADA)[J]. Eur J Cardiothorac Surg, 2016, 49(2):44-52.
[3] Sun L, Qi R, Chang Q, et al. Surgery for acute type A dissection with the tear in the descending aorta using a stented elephant trunk procedure[J]. Ann Thorac Surg, 2009, 87(4):1177-1180.
[4] 孙立忠, 刘宁宁, 常谦, 等. 主动脉夹层的细化分型及其应用[J]. 中华外科杂志, 2005, 43(18):1171-1176. SUN Lizhong, LIU Ningning, CHANG Qian, et al. The application of modified classification of the aortic dissection[J]. Chinese Journal of Surgery, 2005, 43(18):1171-1176.
[5] 董力, 石应康, 田子朴, 等. 心脏机械瓣膜替换术后低强度抗凝治疗[J]. 中华外科杂志, 2003, 41(4):250-252. DONG Li, SHI Yingkang, TIAN Zipu, et al. Low intensity anticoagulation therapy after mechanical heart valve replacement[J]. Chinese Journal of Surgery, 2003, 41(4):250-252.
[6] Yang S, Li X, Chao B, et al. Abdominal aortic intimal flap motion characterization in acute aortic dissection: assessed with retrospective ECG-gated thoracoabdominal aorta dual-source CT angiography[J]. PLoS One, 2014, 9(2): e87664.
[7] 刘文, 王锡明, 段艳华, 等. CTA多期动态重建显示腹主动脉夹层内膜搏动的应用价值[J]. 山东大学学报(医学版), 2016, 54(3):1-5. LIU Wen, WANG Ximing, DUAN Yanhua, et al. The valve of multiphase dynamic reconstruction with CTA to the intimal flap motion of abdominal aortic dissection[J]. Journal of Shandong University(Health Science), 2016, 54(3):1-5.
[8] 斐文楠, 唐渝平. 35例主动脉夹层的诊断及内科治疗[J]. 重庆医学, 2007, 36(11):1081. PEI Wennan, TANG Yuping. Diagnosis and physical therapy in 35 cases of aortic dissection[J]. Chongqing Medicine, 2007, 36(11):1081.
[9] Zhao X, Sun LZ, Zheng J, et al. Early influence of valve-related anticoagulation on false lumen thrombosis in aortic dissection patients after stented elephant trunk surgery[J]. Thorac Cardovasc Surg, 2010, 58(5):271-275.
[10] Song SW, Chang BC, Cho BK, et al. Effects of partial thrombosis on distal aorta after repair of acute DeBakey type I aortic dissection[J]. J Thorac Cardiovasc Surg, 2010, 139(4):841-847.
[11] Di Eusanio M, Castrovinci S, Tian DH, et al. Antegrade stenting of the descending thoracic aorta during DeBakey type 1 acute aortic dissection repair[J]. Eur J Cardiothorac Surg, 2014, 45(6):967-975.
[12] Ma WG, Zhang W, Wang LF, et al. Type A aortic dissection with arch entry tear:Surgical experience in 104 patients over a12-year period[J]. J Thorac Cardiovasc Surg, 2016, 151(6):1581-1592.
[13] Evangelista A, Salas A, Ribera A, et al. Long-term outcome of aortic dissection with patent false lumen: predictive role of entry tear size and location[J]. Circulation, 2012, 125(25):3133-3141.
[14] Blunt DM, Impallomeni MG. Warfarin-associated thoracic aortic dissection in an elderly woman[J]. Age Ageing, 2004, 33(2):199-201.
[15] Kantelhardt SR, Pasnoori V, Varma J, et al. Recurrent aortic dissection in Marfans syndrome: possible effects of anticoagulation[J]. Cardiol Rev, 2003, 11(4): 240-243.
[1] LIU Wen, WANG Ximing, DUAN Yanhua, YANG Shifeng, JI Xiaopeng, KANG Rui. The value of multiphase dynamic reconstruction with CTA to the intimal flap motion of abdominal aortic dissection [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(3): 50-54.
[2] LI Gang1,2, MA Xiang-xing3,ZHANG Hua-yi2, TIAN Ben-xiang2,HAN Wu-shi2, YU De-xin3, WEI Cong-xin3. Value of the dual-source CT virtual endoscopy in the assessment of thoracic aortic dissection [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2011, 49(4): 98-102.
[3] SUN Yong-hui, ZOU Cheng-wei, LI De-cai, LI Hong-xin, WANG Zheng-jun, ZI Jie, ZHANG Wen-long, ZHANG Hai-zhou, FAN Quan-xin, WANG An-biao. Surgical treatment of Stanford type A aortic dissection [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2011, 49(1): 71-.
[4] LI Bin1, SUN Lizhong2, ZHAO Xin1, ZHENG Jun2, CHANG Qian1,YU Cuntao1, ZHU Junming2, LIU Yongmin2. The early and mid-term result of the stened elephant trunk technique for the treatment of extensive thoracic aortic aneurysms:A Meta-Analysis [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2010, 48(6): 92-.
[5] SHANG Hong1, ZHU Yuan-yuan2, WANG Fu-fang1, QI Xiang-min3. Detection of coagulation and hemostasis and its significance in  patients with recurrent aphthous ulcer [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2010, 48(12): 86-89.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!