Abstract 14984: Cervical Branch Re-entry in Patients With Type A Acute Aortic Dissection is Related to a Patent False Lumen in the Aortic Arch and Enlargement After Ascending Aortic Replacement

Background: In some patients with Stanford type A acute aortic dissection (A-AAD) who undergo resection of the entry site by ascending aortic replacement, the aortic arch false lumen is not thrombosed postoperatively, leading to late enlargement. This is attributed to blood leaking into the false lumen at the distal anastomosis. In addition, we hypothesized that a re-entry tear occurring in the distal part of cervical branches can act as an entry after operation. Patients and Methods: We retrospectively studied 85 patients (49 men; mean age 62 ± 12 years). Computed tomographic (CT) scans were evaluated before and after ascending aortic replacement, performed from 2006 through 2014. Patients with intramural hematoma were excluded. The presence of a patent false lumen in one or more cervical branches on preoperative CT was defined as cervical branch re-entry. Results: On preoperative CT, 41 patients (48%) had cervical branch re-entry. The prevalence of hypertension (61% vs. 84%, P = 0.027) and sex (proporti...