title: Management of descending aortic dissection.
abstract: The optimal timing of surgery with Stanford type B aortic dissection remains controversal. In acute-phase cases, surgical mortality is so high that medical treatment is preferable unless there are major complications. To guide the choice of medical versus surgical therapy we use survival analysis in patients with acute uncomplicated/complicated and chronic uncomplicated/complicated descending aortic dissection. Between 1992 and 1993 49 patients were diagnosed with Stanford type B aortic dissection. Emergent surgery was performed in 4 patients for rupture or impending rupture, elective surgery was done in 12 patients. The remaining 33 patients were treated medically. Our results support the continued use of medical management as the primary treatment for uncomplicated acute aortic dissection, with surgical therapy being reserved for those patients with complications such as rupture, expansion, continuing pain or ischemia of distal vascular beds.
authors.affiliation: Dept. of Thoracic and Vascular Surgery, University of Ulm.
authors.forename: K H
authors.initials: KH
authors.lastname: Orend
authors.forename: F
authors.initials: F
authors.lastname: Liewald
authors.forename: B
authors.initials: B
authors.lastname: Kirchdorfer
authors.forename: L
authors.initials: L
authors.lastname: Sunder-Plassmann
mesh_terms: D000784:Aortic Dissection / Q000145:classification / Q000175:diagnosis / Q000628:therapy; D017544:Aortic Aneurysm, Abdominal / Q000145:classification / Q000175:diagnosis / Q000628:therapy; D006801:Humans