Dissection of the thoracic aorta. A comparison between medical and surgical treatment.
We have reviewed 113 patients with acute thoracic aortic dissection seen between 1965 and 1979. There were no "diagnostic" symptoms or signs of acute dissection, and diagnosis could only be reliably made by aortography. The latter also allowed typing of the dissection (De Bakey classification) which permitted appropriate therapy to be instituted. Aortography should be performed early because of the high mortality of this condition within the first 24 hours. Early surgery is warranted in all patients with Type I dissection since it significantly increases long term survival: 40% 5 year-survival for surgical treatment compared with 13% survival for medical treatment (p less than 0.01). There is no significant difference in long or short term survival for patients with Type III dissection whether patients are treated medically or surgically.
D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D001013:Aorta, Thoracic; D001014:Aortic Aneurysm / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D006328:Cardiac Catheterization; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies