title: Surgical treatment or conservative therapy for stanford type a acute aortic dissection with a thrombosed false lumen.
abstract: OBJECTIVE
  Optimum treatment for acute aortic dissection (AAD) with a thrombosed false lumen (thrombosed AAD) remains controversial. We evaluated the outcome of thrombosed AAD according to treatment strategy.
  
  
  METHODS
  We examined 280 patients with AAD, of which 30 had thrombosed AAD. We compared computed tomography findings, cardiac performance, and clinical course in 28 of these patients. Patients were divided into three groups for the comparison: Group E (emergency surgery), Group C (conservative therapy), and Group S (conservative therapy switched to emergency surgery).
  
  
  RESULTS
  In Group E (n = 13), one patient died and 12 survived. In Group C (n = 10), all patients were discharged, of which two died of cancer and two of the remaining eight survivors underwent subsequent elective surgery. In Group S (n = 5), one patient died and four survived following surgery.
  
  
  CONCLUSIONS
  It was hard to predict re-dissection or rupture following conservative treatment for thrombosed AAD. Basically, we should perform emergency surgery following the diagnosis of thrombosed AAD, particularly in complicated cases such as those with pericardial effusion, tamponade, and large aorta. Conservative therapy has a very limited application in patients with the initial stages of thrombosed AAD.
authors: Department of Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan.
authors: Takashi
authors: T
authors: Ando
authors: Toshiya
authors: T
authors: Kobayashi
authors: Hitoshi
authors: H
authors: Endo
authors: Tokuichiro
authors: T
authors: Nagata
authors: Hirokuni
authors: H
authors: Ono
authors: Takamaro
authors: T
authors: Suzuki
authors: Hiroshi
authors: H
authors: Murakami
authors: Masahide
authors: M
authors: Chikada
authors: Haruo
authors: H
authors: Makuuchi
keywords: AAD with a thrombosed false lumen (thrombosed AAD); acute aortic dissection (AAD); conservative therapy; surgical treatment
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