Background
The renal artery is often involved in aortic dissection, leading to kidney ischaemia
and renal dysfunction. However, some patients with aortic dissection with combined
renal artery involvement do not show clinical renal dysfunction. This study aimed
to analyse the relationship between renal artery involvement and renal function.
Methods
Data and images were collected from 79 patients (Group A), in Beijing Anzhen hospital
between January 2015 and December 2017, who had type A aortic dissection, in order
to analyse the relationship between renal artery involvement and serum creatinine.
In order to further analyse the relationship between renal artery involvement and
single kidney function, data from 27 patients (Group B) with aortic dissection from
August 2018 to October 2018 were collected. Renal dynamic imaging was conducted, and
clinical and image data were recorded.
Results
Results showed that patients with one partially occluded renal artery had higher variance
of serum creatinine after surgery compared with patients with one false-lumen renal
artery (5.8±22.7 μmol/L vs –18.7±22.7 μmol/L; p=0.003). The glomerular filtration
rate of a single kidney that had a partially occluded renal artery was lower than
that of a single kidney with a normal renal artery (37.77±9.57 vs 42.73±10.54; p=0.04).
Conclusions
A partially occluded renal artery in aortic dissection was associated with impaired
renal function after surgery, even though patients did not present high serum creatinine.
More attention should be paid to those experiencing aortic dissection.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Heart, Lung and CirculationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- The IRAD classification system for characterizing survival after aortic dissection.Am J Med. 2013; 126: 730.e19-730.e24
- Management strategies for type A dissection complicated by peripheral vascular malperfusion.Ann Thorac Surg. 2004; 77: 1309-1314
- Fate of distal aorta after frozen elephant trunk and total arch replacement for type A aortic dissection in Marfan syndrome.J Thorac Cardiovasc Surg. 2018; https://doi.org/10.1016/j.jtcvs.2018.07.096
- Midterm outcomes of endovascular repair for Stanford type b aortic dissection with aberrant right subclavian artery.J Vasc Interv Radiol. 2019; https://doi.org/10.1016/j.jvir.2019.02.001
- Malperfusion syndromes in aortic dissections.Vasc Med. 2016; 21: 264-273
- Glomerular filtration rate estimation in people older than 85: comparison between CKD-EPI, MDRD-IDMS and BIS1 equations.Nefrologia. 2017; 37: 172-180
- Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury.Crit Care. 2007; 11: R31
- Thoracic endovascular repair for acute complicated type B aortic dissections.J Vasc Surg. 2019; 69: 318-326
- Management of acute type b aortic dissection; adsorb trial.J Thorac Cardiovasc Surg. 2013; 145: S202-S207
- Aortic remodeling in acute type A aortic dissection after frozen elephant trunk implantation.Indian J Thorac Cardiovasc Surg. 2019; 35: 112-117
- The dissected aorta: part III. Anatomy and radiologic diagnosis of branch-vessel compromise.Radiology. 2019; 203: 37-44
- Renal arterial disease and hypertension.Med Clin North Am. 2017; 81: 1199
- Treatment of patients with aortic dissection presenting with peripheral vascular complications.Ann Surg. 1990; 212: 705-713
- Renal artery stenosis.Cardiol Clin. 2015; 33: 59-73
- A single-center experience treating renal malperfusion after aortic dissection with central aortic fenestration and renal artery stenting.J Vasc Surg. 2008; 47 (discussion 10–1): 903-910
- Percutaneous interventions for treating ischemic complications of aortic dissection.Eur Radiol. 2009; 19: 488-494
Article info
Publication history
Published online: December 11, 2021
Accepted:
November 12,
2021
Received in revised form:
December 1,
2020
Received:
September 9,
2019
Identification
Copyright
© 2021 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.
