Outlook of non operated type B aortic dissection with special reference to the incidence of degenerative abdominal aortic aneurysm (AAA). One center study.
OBJECTIVE
to determine the value of pharmacological treatment of type B aortic dissection (B AD) in face of new forms of treatment.


METHODS
this is a retrospective study of the period from 1990 to 2000. Files of 81 patients have been reviewed and completed by questionnaires.


RESULTS
Two B AD died after admission without any treatment, 10 were operated on with 7 discharged alive (group I); 69 received hypotensive agents and beta-blockers, 65 were discharged alive (group II). Late mortality of the group I is 3/7, not related with B AD. Late mortality after mean follow-up of 56.8 months is 27/65 with 4/27 related to B AD (4 ruptures, 2 operated on). Non fatal secondary surgery amounts 5 in 4 patients. Total B AD aortic events comprise 8/65 patients. Type A AD were operated on successfully (8 : 4 before B AD, and 4 after B AD). Degenerative abdominal aortic aneurysms were present, operated (9) or not (3), in the history of patients and 3 more appear subsequently. At 10 years, actuarial survival is 40% +/- 18.


CONCLUSIONS
in non-complicated cases of B AD, medical treatment is a reasonable choice, provided that a strict follow-up of the thoracic abdominal aorta is performed.
Quaniers
J
J
Department of Cardiovascular and Thoracic Surgery, University Hospital of Liège, Liège, Belgium.
Creemers
E
E
Limet
R
R
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D017542:Aneurysm, Ruptured / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D017544:Aortic Aneurysm, Abdominal / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies
D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents