Outcome of medically treated Stanford type B aortic dissection

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A Iguchi1, K Tabayashi

  • 1Department of Thoracic and Cardiovascular Surgery, Tohoku University School of Medicine, Sendai, Japan.

Japanese Circulation Journal
|April 29, 1998
PubMed

Insights

Medical therapy for uncomplicated type B aortic dissection is effective. This approach led to survival for all patients, with acceptable long-term outcomes and manageable aortic enlargement.

Area of Science:

  • Cardiovascular Medicine
  • Vascular Surgery
  • Medical Therapy

Background:

  • Optimal treatment for uncomplicated type B aortic dissection is debated.
  • Medical therapy is a viable option for these patients.

Purpose of the Study:

  • To evaluate the efficacy of exclusive medical therapy for acute type B aortic dissection.
  • To assess long-term outcomes, including aortic enlargement and survival rates.

Main Methods:

  • Retrospective analysis of 43 patients with acute type B dissection treated medically.
  • Regular aortography and enhanced computed tomography for aortic diameter evaluation.
  • Follow-up for up to 5 years post-discharge.

Main Results:

  • All 43 patients survived the acute phase and were discharged alive.
  • No deaths occurred related to aortic dissection.
  • Freedom from aortic enlargement was 100% at 1 year, 91% at 3 years, and 86% at 5 years.
  • Three patients required surgery for chronic aortic enlargement; 3 others were managed medically.

Conclusions:

  • Exclusive medical therapy is a safe and effective treatment for uncomplicated type B aortic dissection.
  • Long-term survival rates are acceptable with medical management.
  • Medical therapy can successfully manage aortic enlargement in selected cases.

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