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Abdominal CT Angiography Before Surgery as a Predictor of Postoperative Death in Acute Aortic Dissection

¹ Department of Thoracic and Cardiovascular Imaging, Louis Pradel Hospital, 59, Blvd. Pinel, Lyon 69394, France.
² Surgical Intensive Care Unit, Louis Pradel Hospital, Lyon 69394, France.
³ Department of Biostatistics, Louis Pradel Hospital, Lyon 69394, France.

OBJECTIVE. The purpose of our study was to search for a relationship between postoperative death in acute aortic dissection and abdominal helical CT findings before surgery.

MATERIALS AND METHODS. We retrospectively included 48 patients admitted to our institution for emergent surgery of acute aortic dissection diagnosed with helical CT angiography. We recorded postoperative deaths and analyzed abdominal helical CT vessels and parenchymal abnormalities, including the presence of dissected abdominal aortic branches, a compressed aortic lumen, and low enhancement of the parenchyma in abdominal organs.

RESULTS. Among the 48 patients, 11 died after surgery. Postoperative death occurred in one of five patients with low enhancement of the parenchyma in one abdominal organ and in seven of eight patients with low enhancement of the parenchyma in at least two abdominal organs. The postoperative death rates strongly correlated with the number of low-enhanced abdominal organs per patient (p < 0.00005) but did not correlate with the number of dissected abdominal aortic branches.

CONCLUSION. The rate of abdominal organs with low enhancement of the parenchyma seen on CT before surgery is a strong factor in outcome in patients with acute aortic dissection. Additional analysis of low enhancement of the parenchyma in abdominal organs on CT might be a useful tool to detect, before surgery, patients at risk of postoperative death.

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