[Long-term surgical results of acute aortic dissection]

Between 1988 and 1997, 69 patients underwent surgery for acute aortic dissection: 65 patients had an acute type A (AcA) and 8 an acute type B (AcB) aortic dissection. The hospital mortalities were 16.9% for AcA and 25% for AcB. Actuarial survival rates including hospital deaths after 5 and 8 years were 70% and 58% for AcA patients and no late death or cardiovascular event occurred in AcB patients during follow-up periods. Freedom from cardiovascular events was 88% and 70% at 5 and 8 years, and freedom from reoperation was 94% at 5 and 8 years for operative survivors of AcA. There were no differences on actuarial survival rates between ascending aortic repair and arch repair, ringed-graft and suture anastomosis, and postoperatively patent false lumen and closed false lumen. There were no differences on freedom from cardiovascular events between ascending aortic repair and arch repair, and ringed-graft and suture anastomosis, however, patients with postoperatively patent false lumen showed significantly lower freedom from cardiovascular events registering 85% and 59% at 5 and 8 years compared with 94% at 5 and 8 years in patients with closed false lumen.