Outcome of medically treated Stanford type B aortic dissection

Optimal treatment for patients with uncomplicated type B dissection remains a matter of debate. From January, 1987, through June, 1996, 43 patients with acute type B dissection were treated exclusively by medical therapy according to our management guidelines. After discharge, aortography and enhanced computed tomography were performed every 6 months to evaluate the diameter of the dissected aorta. All 43 patients survived the acute phase and were discharged alive from the hospital. There was no death related to aortic dissection. Three patients underwent surgical treatment in the chronic phase because of aortic enlargement. Aortic enlargement in 3 additional patients was managed medically. The values for freedom from aortic enlargement for 43 patients at 1, 3, and 5 years were 100%, 91%, and 86%, respectively. The long-term survival rates of patients treated medically and discharged from the hospital are acceptable.