[Is delayed surgical repair admitted for the thrombosed aortic dissection?].
The initial treatment for the thrombosed aortic dissection is still controversial. Accordingly, we sought to evaluate the strategy of its surgical repair. Ninety-six (35 type A and 61 type B) acute thrombosed aortic dissection were studied retrospectively. Initially all of them were treated medically. The ratio of the false and the true lumen (F/T ratio) was calculated on the onset. The uncontrollable cardiac tamponade, recanalization, large ulcer-like projection (ULP) and enlargement of the dissected aorta had a delayed surgical repair during the follow-up period. Eighteen of the type A and 14 of the type B were surgically treated and showed good result. The 1- and 5-year survival rates and the event-free survival rates for the type A and the type B were almost equal with no statistical difference. The mean F/T ratio for the type A was 31% for the operative and 51% of the nonoperative cases (p = 0.007). The maximum size of the initial aorta of the operative cases was larger than that in the nonoperative for the type B. The conservative therapy for the thrombosed aortic dissection decreased the number of the unnecessary operation and the strategy of the delayed surgical repair was justified properly.
Myojin
Kazuhiro
K
Division of Cardiovascular Surgery, Hokkaido Cancer Center, Sapporo, Japan.
Ishibashi
Y
Y
Ishii
K
K
Kawasaki
M
M
Oka
J
J
Kunishige
H
H
Shingu
Y
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000401:mortality / Q000601:surgery*; D000959:Antihypertensive Agents / Q000008:administration & dosage; D001011:Aorta / Q000601:surgery; D001014:Aortic Aneurysm / Q000401:mortality / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000401:mortality / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D013927:Thrombosis / Q000401:mortality / Q000601:surgery*; D013997:Time Factors; D014656:Vascular Surgical Procedures / Q000379:methods
D000959:Antihypertensive Agents