[Acute aortic dissections. Hospital outcome of 186 cases].
OBJECTIVE
To determine in hospital outcome acute aortic dissection patients.


METHODS
We revised 186 consecutive cases (up to 14 days of dissection), in a period of 6 years. The patients were divided according to Daily's classification (types A and B).


RESULTS
Type A--127 cases: a) 75 were surgically treated (37 died); b) 2 were medically treated (both died); c) 39 died before the definitive treatment could be initiated; d) 11 died misdiagnosed or undiagnosed. The total mortality was 70.0%. Type B--59 cases: a) 11 complicated cases were surgically treated (6 died); b) 40 were medically treated (8 died); c) 7 died before the definitive treatment could be initiated; d) one died misdiagnosed. The total mortality was 37.25%. In summary, 41.4% of the patients survived. 28.4% died despite the definitive treatment, 24.7% died before the definitive treatment could be initiated and 6.4% died without the correct diagnosis.


CONCLUSIONS
The acute aortic dissection is a dramatic situation, mainly type A. In this type of dissection many patients (41%) died misdiagnosed, undiagnosed or without enough time to surgical therapy. So, an earlier diagnosis and treatment are imperative.
Vianna
C de B
Cde B
Instituto do Coração do Hospital das Clínicas-FMUSP, São Paulo.
Barretto
A C
AC
Cesar
L A
LA
Mady
C
C
Stolf
N
N
Bellotti
G
G
Jatene
A D
AD
Pileggi
F
F
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery; D001014:Aortic Aneurysm / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged
Dissecções agudas da aorta. Evolução hospitalar de 186 casos.