Preliminary findings in quantification of changes in septal motion during follow-up of type B aortic dissections

The management algorithm for type B aortic dissections has remained essentially unchanged over the past several decades despite advances in both imaging technology and options for endovascular management of the aorta. In part, this may be due to the underutilization of dynamic imaging modalities with their potential to evaluate the diseased aorta on an individualized basis. Although intra-arterial septum (IS) stiffness has long been accepted as a marker for chronicity of a dissection, changes in IS mobility over time have not yet systematically been investigated. In this study, we have demonstrated that IS motion can be quantified with dynamic magnetic resonance imaging methods (in particular, two-dimensional phase-contrast magnetic resonance imaging). The first results presented here indicate that IS motion may be reduced over time, reaching statistical significance at long-term follow-up. Variable behavior at presentation and midterm also indicate that basing management on our current definitions of acute and chronic based on time since presentation alone may not be reasonable. These patterns could determine which patients are more likely to benefit from interventions and which are likely to have poor outcomes from thoracic endovascular repair.