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Related Experiment Videos

Subtypes of acute aortic dissection.

S L Lansman1, J N McCullough, K H Nguyen

  • 1Department of Cardiothoracic Surgery, The Mount Sinai Medical Center, New York, New York 10029, USA.

The Annals of Thoracic Surgery
|July 3, 1999
PubMed
Summary

This study on acute aortic dissection found that repairing the primary intimal tear site in type A dissections yielded consistent outcomes. A selective surgical approach for type B dissection proved effective.

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Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Vascular Surgery

Background:

  • A 12-year experience with surgical repair of acute aortic dissection.
  • Focus on identifying and replacing the aortic segment with the primary intimal tear.

Purpose of the Study:

  • To evaluate a policy of aortic segment resection for acute aortic dissection.
  • To analyze outcomes based on the location of the intimal tear.

Main Methods:

  • Urgent surgery for Type A dissection.
  • Selective surgical criteria for Type B dissection (e.g., aortic dilatation > 5 cm).
  • A new classification system for acute dissection based on intimal tear location.

Main Results:

  • 168 acute dissections (139 Type A, 29 Type B).

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  • Intimal tear sites: ascending aorta (83), arch (32), descending aorta (29).
  • Hospital mortality: 13.7% for Type A, 0% for Type B. Ten-year survival varied by tear location in Type A.

    • Conclusions:

    • Systematic resection of the primary tear in Type A dissection resulted in similar outcomes across subtypes.
    • Selective surgical management of Type B dissection achieved excellent results.