[Closing aortic dissection--it's clinical manifestation and treatment]

15 cases (31.6%) with closing aortic dissection have been experienced among 46 cases in acute dissecting aneurysm of the aorta during past 8 years and 9 months. Ulcer like projection was recognized in 81.8% of closing aortic dissection. Serum FDP level measured within 48 hours after onset was significantly lower and serum fibrinogen level was significantly higher in closing aortic dissection than in patent false lumen type. Especially, the case with FDP < or = 10 micrograms/ml, fibrinogen > or = 300 mg/dl is strongly suspected as closing aortic dissection. There was no death among patients with closing aortic dissection except one who died after operation at chronic phase. These patients were well controlled by medical therapy except one who received emergent operation. We showed 3 interesting cases with Stanford A type closing aortic dissection. One patient was treated surgically because of cardiac tamponade and shock, but the other two patients were treated medically. From these results, we conclude that medical therapy should be a first choice for patients with closing aortic dissection regardless of Stanford classification.