[Acute aortic dissection. Prognostic factors, therapeutic indications. 137 cases (author's transl)]

137 patients (92 men and 45 women) with an average age of 58 years (range: 19 to 90 years) were hospitalised between January 1970 and June 1977 for acute aortic dissection. In 107 patients (and in 91 cases during the first 24 hours of hospitalisation) aortography was performed. This examination was found to be greatly reliable when its findings were compared with those at surgical exploration. In the absence of surgical treatment, 69 patients died and 5 survived. Amongst the patients undergoing surgery, 37 died and 27 survived. With the exception of type III dissections, survival appeared to be markedly increased by surgical treatment. Preoperative factors indicative of a poor prognosis included a neurological deficit of central origin, oligoanuria, raised blood urea, disseminated intravascular coagulation and dissection of the superior mesenteric artery or the coeliac trunk.