[Acute aortic dissection. Therapeutic strategies and results].
OBJECTIVE
To analyse early and medium-term results of patients (pts) with acute aortic dissection (DAO) regarding the importance of the different therapeutic modalities adopted.


METHODS
Retrospective study of the cases with DAO admitted in the cardiology intensive care unit of Santa Marta Hospital.


METHODS
46 pts (aged 25 to 80 years) with the diagnosis of DAO from January/1989 throughout December/1993.


RESULTS
early mortality rate (30 days) was 36%. DAO type A Two cases were treated only with medical therapy for they suffer from severe associated pathology. Twenty eight pts were treated surgically. In this group mortality concerning time passed from the beginning of the symptoms throughout the surgery was: < 24 h-31%, 24-72 h-40%, > 72 h-63%. Among 17 discharged pts mortality occurred in 7% during the first year. DAO type B In pts with uncomplicated Stanford type B DAO survival was 90%. Emergency surgery was performed in pts who developed complications such as rupture of the aorta, occlusion of major arteries or extension of dissection. In this particular group mortality was 66%. Among 11 discharged pts with type B DAO 9% died within one year. During the follow-up period of 17.4 +/- 14.8 months one third of the pts discharged from hospital had clinical events.


CONCLUSIONS
despite new advances in diagnostic and therapeutic approaches, DAO still's reported as a relatively high hospital mortality situation. Remove pts to an institution with ability to perform quickly the correct diagnosis and treatment becomes essential. Clinical presentation, type of DAO, surgery timing when indicated and major complications were of particular importance in the prognosis of pts with DAO. The frequency of cardiovascular events in pts who left the hospital alive emphasized the need to maintain blood pressure within normal limits.
Oliveira
M
M
Serviço de Cardiologia, Hospital de Santa Marta.
Quininha
J
J
Rosário
L
L
Galrinho
A
A
Pitta
L
L
Sousa
M J
MJ
da Silva
N
N
Ferreira
R
R
Roquette
J
J
Castelão
N
N
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000628:therapy*; D001014:Aortic Aneurysm / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
Dissecção aguda da aorta. Estratégias terapêuticas e resultados.