Management and long-term outcome of aortic dissection.
All 163 patients admitted to one institution between 1975 and 1988 with aortic dissection were reviewed. Type I and type II patients received grafting of the ascending aorta, with an intraoperative mortality rate of 11%. For type III dissection, management was medical in 53 patients, while 19 required surgery for aortic rupture or expansion, with an intraoperative mortality rate of 11%. The 9- or 10-year survival rates were 29%, 46%, and 29% for types I, II, and III respectively. Of 135 patients with primary aortic dissection, 17 (13%) required subsequent aortic surgery. Cause of late death was other cardiovascular disease in 38%, rupture of another aortic segment in 18%, sudden death in 24%, and other medical conditions in 21%. Although operative therapy for types I and II dissections and reserving operation for selected type III dissections provides acceptable long-term survival, careful follow-up is necessary due to concurrent cardiovascular disease and residual aortic disease.
Glower
D D
DD
Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710.
Speier
R H
RH
White
W D
WD
Smith
L R
LR
Rankin
J S
JS
Wolfe
W G
WG
D000046:Academic Medical Centers; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000145:classification / Q000401:mortality / Q000601:surgery*; D001011:Aorta; D001013:Aorta, Thoracic; D001014:Aortic Aneurysm / Q000145:classification / Q000401:mortality / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D002423:Cause of Death; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D010043:Outcome and Process Assessment, Health Care; D011379:Prognosis; D012086:Reoperation; D012189:Retrospective Studies; D015996:Survival Rate