[Early and long-term outcome for surgical treatment of acute aortic dissection]

This study was undertaken to determine the factors that influence the final outcome after the operation of acute aortic dissection. Twenty-one patients, the median age was 59 years (range 44 to 81), were operated at acute phase in 92 admitted into our hospital during the 13-year period between May 1985 and Jan. 1998. Preoperative complications included cardiac in 5 and ruptured with shock in 7, myocardial ischemia in 3 and stroke in 4. The ascending aortic reconstruction (9, 43%), ascending aorta and arch reconstruction (7, 33%) and other procedures (4, 19%) were performed using cardiopulmonary bypass with deep hypothermia and circulatory arrest or selective cerebral perfusion. The 30-day operative deaths were 6 (29%) and 5 (24%) late death occurred. Three out of 5 were aneurysm related deaths. The cause specific survival rates were 61% at 5 years and 51% at 8 years. The multivariably determined risk factors for death were as follows (p < 0.05): preoperative FDP; bleeding volume; postoperative renal complications; postoperative stroke.