Fate of the dissected aortic arch after ascending replacement in type A aortic dissection†
Bibliographic record
Abstract
OBJECTIVES: To evaluate the fate of a dissected aortic arch after limited surgical repair of type A aortic dissection. METHODS: Of the 271 patients operated for acute type A dissection between 2001 and 2015, 86 (age 57 ± 13 years, 74% men) with predischarge computed tomographic (CT) scans had a residual dissection in the arch. Aortic diameters, lengths, ellipticity and communications between lumina were assessed using predischarge and follow-up CT scans. The median CT scan follow-up was 31 months (first quartile 15, third quartile 52). RESULTS: The largest increase in the total aortic diameter at follow-up was 20 mm distal to the left subclavian artery (median +4.0 mm; first quartile +1.5, third quartile +9.2 mm; P = 0.004), with an average growth rate of 1.5 mm/year (first quartile 0.6, third quartile 3.9 mm). The true lumen diameter was unchanged at follow-up. At least 1 communication between the true and the false lumina was observed in 80% of patients on the predischarge CT scan, and 70% had communications at the distal aorta-graft anastomosis. Accelerated increase in the diameter of the dissected aorta was associated with the number of communications between the lumina, communication at the distal anastomosis and false lumen perfusion (all, P < 0.001). CONCLUSIONS: Dissection of the residual aortic arch leads to aortic growth that may result in an aneurysm requiring treatment. The number of communications between the lumina, communication at the distal anastomosis and false lumen perfusion are associated with the accelerated aortic growth. Endovascular repair may be difficult due to the small true lumen and the presence of many communications between the lumina.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".