Serial quantitative follow-up evaluation of morphologic changes of the descending thoracic aorta in chronic stable aortic dissection by transesophageal echocardiography (TEE)

The aim of this serial 3 year follow-up study in 42 clinically stable patie nts with chronic aortic dissection was to assess quantitatively morphologic changes of the descending thoracic aorta (AD) using transesophageal echoca rdiography (TEE). Communicating dissections (ca) were present in 16/19 pati ents with operated type I and in 11/23 patients with type III AD wherease 1 2/23 type III AD according to De Bakey were non-communicating (nc). Diametr al enlargement of the desc. thoracic aorta was 4 mm (mean value) at 1 year in all patients, 5.9 mm in type I ca, 7.2 mm in type III ca but only 3.1 mm in type In nc at 3 years. The ratio between true lumen and false lumen (FL ) changed in ca AD from 1:2 to 1:3 over the period of 3 years but remained constant at 1:1 in ncAD. Progressive thrombosis of the false lumen (FL) occ urred in 76 % of patients but complete thrombosis of the FL occurred in onl y 6 % of type I ca, 18 % type III ca but in 84 % of type III ne patients. Our results confirm observations that non-communicating dissections seem to have a more favorable outcome and less aneurysmal dilatation compared to c a dissection.