[Acute thrombosed aortic dissection--its clinical manifestation and treatment for Stanford A type]

Ten patients (mean age of 63 years old) with acute thrombosed aortic dissection (ATAD) have been evaluated among 31 aortic dissections during past 10 years (from 1985 to 1995). The six cases are Stanford A type and others are Stanford B type. The mean maximal diameter of aorta was 52 +/- 6 mm in Stanford A type and 41 +/- 4 mm in Stanford B type. The ratio of true lumen was 78 +/- 14% to that of whole horizontal section area in thrombosed type and 34 +/- 19% in opacified type dissection. We had chosen conservative treatment for all ATAD. However, five patients with Stanford A type dissection needed to be operated on in short term periods. Three patients were operated upon within three days from onset, and another two patients were operated on 34th and 37th day from onset, respectively. ATAD is firstly treated medically and its prognosis is generally well. However, we proposed here that the conservative treatment for ATAD, especially Stanford A type dissection, must be reconsidered because of our many operations for ATAD in the follow-up periods.