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Acute type B aortic dissection: surgical therapy.

Steven L Lansman1, Christian Hagl, Daniel Fink

  • 1Department of Cardiothoracic Surgery, The Mount Sinai School of Medicine, New York, New York 10029, USA. sllhttxmd@msn.com

The Annals of Thoracic Surgery
|November 21, 2002
PubMed
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Urgent surgery for acute type B aortic dissection has low mortality and paraplegia risk. Early intervention may benefit selected patients, showing good long-term survival rates.

Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Vascular Surgery

Background:

  • Acute type B aortic dissection carries significant surgical mortality risks.
  • This study reports outcomes for 34 patients undergoing urgent surgery within 14 days of symptom onset.
  • Patients met specific criteria for operative intervention during the acute phase.

Purpose of the Study:

  • To evaluate the perioperative and long-term outcomes of urgent surgical intervention for acute type B aortic dissection.
  • To assess the safety and efficacy of surgical repair in patients with specific indications.
  • To inform clinical decision-making regarding the timing of surgery for acute type B aortic dissection.

Main Methods:

  • Retrospective analysis of 34 consecutive patients undergoing urgent surgery for acute type B aortic dissection.

Related Experiment Videos

  • Indications included persistent pain, exsanguination, malperfusion, aortic enlargement, and uncontrolled hypertension.
  • Surgical techniques involved descending aorta resection, hypothermic circulatory arrest, and various adjuncts like CSF drainage.

    • Main Results:

    • No hospital mortality was observed.
    • Major complications occurred in 47% of patients, including respiratory issues, infections, and neurological events (one paraplegia).
    • Five- and 10-year survival rates were 80% and 57%, respectively, with a mean follow-up of 5.8 years.

    Conclusions:

    • Urgent surgery for acute type B aortic dissection is associated with low perioperative mortality and paraplegia risk.
    • Patients experience relatively few long-term aorta-related complications.
    • Earlier surgical consideration is warranted for appropriately selected patients with acute type B aortic dissection.