J.Jpn. Surg. Soc.. 81(9): 966-969, 1980

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Report on the annual meeting

SURGICAL AND NONSURGICAL THERAPY FOR DISSECTING ANEURYSMS OF THE THORACIC AORTA. CONSIDERATION OF SURGICAL INDICATION

The results of both surgical and nonsurgical therapy for dissecting aneurysms of the thoracic aorta were reviewed to evaluate the surgical indication. Between 1960 and 1980, 56 patients with dissecting aneurysms of the thoracic aorta were seen in our institution. Thirty two patients were treated surgically with 21 survivors (66%). Thirteen patients of acute type and eleven patients of chronic type were treated nonsurgically with 62% of one year survival rate and 46% of two year survival rate in the former group. Acute dissecting aneurysms of the thoracic aorta should be initially treated with intensive medical therapy and followed by surgical intervention 6 weeks or longer after the onset. If acute cases are complicated with rupture of aneurysm, severe aortic regurgitation, or occlusion of the major branches, the emergency operation is indicated. Chronic cases associated with severe aortic regurgitation, development of saccular aneurysm, progression of dissection or recurrence of pain are indicated for surgery. However, surgical indication and surgical technique for chronic extensire dissection, particularly DeBakey IIIb, need further evaluation.

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