[The prognosis and the surgical indications of DeBakey type III dissecting aortic aneurysm].
In order to determine the indications of operation for dissecting aortic aneurysm of DeBakey type III, therapeutic results obtained from 60 cases (11 with type IIIa and 49 with type IIIb) treated at our department during the 19-year period until the end of 1984 were analyzed as well as their distant prognosis. Since 12 cases (20%), who visited our department during the acute phase, were all abated to the subacute phase by hypotensive treatment, and since only one of the 12 cases died from pneumonia 5 weeks after the onset, it was thought that the operation during the acute phase is in most cases not necessary. We applied operation when there was a large false lumen, a regional protrusion, rupture or impending rupture. Out of the 60 cases, 25 (42%; 7 with type IIIa and 18 with type IIIb) underwent operation, and 3 of them (12%), including one ruptured case during the chronic phase, died due to the operation. Among cases with type IIIa, a non-operated case died of a related cause (rupture) during distant period, but none of operated cases died. Among discharged cases with type IIIb, 4 of 16 operated cases (25%) died of related causes during distant periods. This mortality did not differ from that of non-operated cases; namely, 8 of 30 non-operated cases died (27%). A 5-year survival rate was also identical between the non-operated and operated cases with type IIIb; namely, about 50% in the 2 groups.(ABSTRACT TRUNCATED AT 250 WORDS)
Ueda
T
T
Kawada
K
K
Soma
Y
Y
Inoue
T
T
D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000601:surgery*; D001014:Aortic Aneurysm / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis