[Operative results and long-term prognosis of aortic dissections]

We retrospectively analyzed the operative results and the long-term prognosis of aortic dissections. Between 1966 and 1996, we operated upon 137 patients with aortic dissection. According to the date of the first operation, they were classified into early (1966, 1985), middle (1985, 1992), and late (1992, 1996) cases. The hospital mortality rates of Stanford type. A patients were 40% (12/30) for early cases, 21 (6/28) for middle cases, and 13% (3/24) for late cases. Those of type-B patients were 10% (3/30) for early cases, 21% (3/11) for middle cases and 6% (1/16) for late cases. Actuarial survival rates for the all operative survivors of type-A patients (n = 60) were 77% at five year and 63% at 10 year. Those of type-B patients were 63% at five year and 20% at ten year. The difference of the two survival curves was significant (p < 0.01). In conclusion, the operative mortality rates for both type-A and type-B aortic dissection have reduced. But the more extended and rationale operation is recommended especially for type-B dissection in order to improve long-term prognosis.