[The shock patients with the cardiac tamponade resulting from acute type A aortic dissection]

Twelve patients with acute type A aortic dissection were admitted at Ohta-Nishinouti Hospital from Jan. 1991 to Mar. 1994. Three of these 12 cases were in shock with cardiac tamponade on arrival at the hospital. Immediate resuscitative management was necessary for these patients, but pericardiocentasis was fruitless in the first case and emergent thoracotomy had led to the aortic rupture. While the second case was the thrombosed type aortic dissection and successfully performed pericardiocentasis, CT findings showed recanalization of the pseudolumen after a day, then we performed the urgent operation. By means of these experiences, the third case was operated quickly in spite of the thrombosed type aortic dissection, and had good result. We concluded that immediate surgical intervention should be taken to the shock patients with cardiac tamponade resulted from acute type A aortic dissection.