[The long-term results of surgical treatment for acute type A aortic dissection]

Between 1992 and 1996, 31 patients with acute type A aortic dissection underwent the surgical treatment on an emergency basis. The overall early mortality rate was 12.3% (4 patients), and the overall 5-year survival rate (calculated by Kaplan-Meier method) was 76.9% respectively. Although there is controversy about the operative procedure whether the aortic arch should be replaced or not in aortic arch dissection in which the primary intimal tear is located at or extends into the arch, the resection of the aortic arch tear and simultaneous arch repair with graft replacement of the ascending aorta would be the acceptable procedure in the long term period with the recent improvement of adjunct technique for the prevention of cerebral ischemia and heart protection. The composite graft replacement of the aortic root is also indicated in patients with acute dissection associated with annuloaortic ectasia or Marfan's syndrome and severely destroyed aortic root with the extension of dissection to the aortic root with acceptable mortality and survival rate in the early and late period.