Management Outcomes Of Acute Type A Aortic Syndrome Presenting With Completely Thrombosed False Lumen In The Ascending Aorta

Introduction: Although the prognosis of acute type A aortic dissection without urgent surgical treatment are known to be dismal, there have been arguments that there may be a subset of hemodynamically stable patients presenting with complete thrombosis of the false lumen (FL) in the ascending aorta, in whom the prognosis may be more benign even without surgery. Represented by “initial medical management and timely surgery of acute type A intramural hematoma”, this strategy for overall thrombosed type A acute aortic syndrome (AAS) has been an issue of debates to date.Hypothesis: Medical treatment in patients with thrombosed FL type A AAS may show favorable clinical outcomes compared with a strategy of initial urgent surgical treatment. Methods: Of a total of 511 patients who were diagnosed as having acute type A AAS from 1997 to 2016, 164 (age 62.2±13.0yrs, 94 females) were identified as having completely thrombosed FL in the ascending aorta with stable hemodynamic conditions, and formed the study subjects...