Abstract
Among aortic dissections, three-channeled aortic dissection, in which two parallel
false lumens are present, is relatively rare. We surgically treated 26 patients with
this type of dissection, they accounted for 7.4% of all 349 patients with aortic dissection
surgically treated between 1978 and May 1997. Their ages ranged from 24 to 77 years
(mean 45 years). The male/female ratio was 1:1. Marfan's syndrome was present in 15
patients and Bentall's-type operation had been performed in 12 patients. Pain at different
times was observed in 19 patients. For preoperative diagnosis, computed tomography
(CT) and magnetic resonance imaging (MRI) were useful. The morphology of the 1st and
2nd false lumens was Stanford type A + type B in 11 patients, type B + type B in 12,
type A + type A in 2, and localized abdominal dissection in 1. Reentry of the second
false lumen was observed in only 3 patients. Descending aortic replacement was performed
in 13 patients, thoracoabdominal aortic replacement in 6, ascending aortic replacement
in 3, and others in 4. Seven patients died in the hospital. There were 4 late deaths
during follow-up for 10–158 months (mean, 58 months). When pain recurred in patients
with aortic dissection, three-channeled dissection should be suspected. The incidence
of this dissection is high in patients with Marfan's syndrome.
