Imaging surveillance for complications after primary surgery for type A aortic dissection

Heart. 2022 Dec 22;109(2):96-101. doi: 10.1136/heartjnl-2022-320881.

Abstract

Acute type A aortic dissection (ATAAD) is a life-threatening condition that requires emergency surgery to avert fatal outcome. Conventional surgical procedures comprise excision of the entry tear and replacement of the proximal aorta with a synthetic vascular graft. In patients with DeBakey type I dissection, this approach leaves a chronically dissected distal aorta, putting them at risk for progressive dilatation, dissection propagation and aortic rupture. Therefore, ATAAD survivors should undergo serial imaging for evaluation of the aortic valve, proximal and distal anastomoses, and the aortic segments beyond the distal anastomosis. The current narrative review aims to describe potential complications in the early and late phases after ATAAD surgery, with focus on their specific imaging findings.

Keywords: aneurysm, dissecting; aortic diseases; cardiac imaging techniques; computed tomography angiography; echocardiography.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Aorta / surgery
  • Aortic Aneurysm, Thoracic* / diagnostic imaging
  • Aortic Aneurysm, Thoracic* / surgery
  • Aortic Dissection* / diagnostic imaging
  • Aortic Dissection* / surgery
  • Aortic Rupture*
  • Aortic Valve / surgery
  • Blood Vessel Prosthesis Implantation* / adverse effects
  • Humans
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / etiology
  • Postoperative Complications / surgery
  • Retrospective Studies
  • Treatment Outcome