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[Acute type B aortic dissection].

Teruhisa Kazui1, Naomi Washiyama

  • 1Department of First Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.

Kyobu Geka. the Japanese Journal of Thoracic Surgery
|September 15, 2004
PubMed
Summary
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Emergency surgery for complicated acute type B aortic dissection is vital. Optimal surgical strategies, including descending aortic replacement or bypass, are crucial for managing rupture or ischemia, with an 11.1% in-hospital mortality rate.

Area of Science:

  • Cardiovascular Surgery
  • Vascular Surgery
  • Thoracic Surgery

Context:

  • Acute type B aortic dissection often requires medical management but necessitates emergency surgery for complications.
  • Complications include rupture, intractable pain, uncontrolled hypertension, large pseudo-lumen, or organ ischemia.
  • Prompt diagnosis and treatment of visceral ischemia are critical.

Purpose:

  • To review the indications and outcomes of emergent surgical interventions for acute type B aortic dissection.
  • To highlight the importance of selecting optimal surgical strategies based on specific patient conditions.
  • To underscore the need for further research into new therapeutic approaches.

Summary:

  • Out of 40 patients with acute type B aortic dissection, 9 (23%) underwent emergent surgical treatment.

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  • Surgical interventions varied, including descending aortic replacement for rupture and bypass/fenestration/thrombectomy for ischemia.
  • The in-hospital mortality rate for surgically treated patients was 11.1%.

    • Impact:

    • This study emphasizes the critical role of timely and appropriate surgical intervention in managing complicated acute type B aortic dissection.
    • It highlights the challenges in diagnosing visceral ischemia and the need for prompt treatment.
    • Further investigation into catheter-based interventions and novel therapeutic strategies is warranted to improve outcomes for high-risk patients.