Maximal Aortic Diameter at Zone 3 Predicts Negative Remodeling After Initial Type a Dissection Repair

Data regarding remodeling of the residually dissected descending thoracic aorta after surgical repair type A aortic dissection (TAAD) are lacking. The current standard care is medical management until maximal diameter (MAD) reaches at least 55 mm, which time prophylactic can be considered to reduce risk rupture. benefit early intervention for patients high negative remains unknown. purpose our study determine if MAD in any single zone, or combination zones, presentation with acute TAAD, associated long-term remodeling. Included were who presented TAAD from 2015 2020 a academic institution. Excluded suffered perioperative death lacked follow-up imaging. each zone was measured on computed tomography reconstructed images using centerline technique. Primary outcome distal remodeling—positive, negative, and stable. Negative defined as >3 mm increase serial surveillance compute scans. Multivariable proportional odds regression Akaike inclusion criterion-guided model selection applied measure effect primary outcome. Outcome likelihood described an plot. Sixty-three included. Initial 3 independently multivariable analysis according criterion-selected (odds ratio, 0.83; 95% confidence interval, 0.70-1.00; P = .039). Each 1-mm initial led 1.2x higher An ≥36mm predictive (Figure). In surviving index repair, ≥36 Further research required these may candidates endovascular prevent Other factors this specific population remain area ongoing investigation.