[Aortic dissection. A 8-year material from health region 5].
At the University Clinic Tromsø 27 and 16 patients with aortic dissection of Stanford type A and B have been admitted during the last eight years. The treatment strategy has been immediate surgery for type A and a conservative strategy consisting of blood pressure reduction and observation for type B. Nine (33%) of the patients with type A dissections were diagnosed either too late for surgery or at autopsy. Two were deemed too ill for operative treatment. One patient with a chronic type A dissection has been followed up without surgery. The remaining 15 were operated on. Four of these (26%) died within 30 days. Apart from a temporary hemiparesis, no sequelae related to the surgical treatment were observed in the remaining 11 patients. Six of the 16 patients with type B dissections were operated on because of organ ischemia or rupture/threatening rupture. Two died within 30 days. One patient had a prolonged postoperative course owing to multiple organ failure and muscle necrosis. Two of the ten patients with type B dissections who were followed up without surgery died during the observation period. These observations indicate a need for a more aggressive approach to the diagnosis and follow-up of aortic dissections.
Myrmel
T
T
Kirurgisk avdeling A Rikshopitalet, Oslo.
Robertsen
S
S
Almdahl
S M
SM
Dahl
P E
PE
Lie
M
M
Sørlie
D G
DG
D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000401:mortality / Q000601:surgery*; D001014:Aortic Aneurysm / Q000401:mortality / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D011379:Prognosis
Aortadisseksjoner. Et åtteårsmateriale fra helseregion 5.