J.Jpn. Surg. Soc.. 81(9): 995-998, 1980

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Report on the annual meeting

TREATMENT OF AORTIC DISSECTIONS―ESPECIALLY THE SURGICAL INDICATIONS

Surgical experiences in 40 patients with aortic dissections were grossly reviewed. Until March 1980, 3 patients with acute dissections were operated upon with 3 deaths from hemorrhage, and 37 patients with chronic dissections were operated upon with 11 postoperative deaths (mortality 29.7%) However, from 1972 through March 1980, 28 patients were operated upon with 5 postoperative deahs. (mortality 17.9%). Annulo-aortic ectasia was combined in 12 of 18 patients with type I and II dissections.
In the long term results of operated patients, two patients in the 37 chronic dissections died about 6 years after operation, and their 11 years survival rate was 57%, while in the 35 medically treated patients with chronic dissections 5 years survival rate was only 20%, and in the type I and II dissections with annulo-aortic ectasia the survival rate was the worst (0% in 2 years survival).
Surgical indications in the chronic type I and II dissections with annulo-aortic ectasia is obvious, while other chronic dissections of all types should also be operated upon when the aneurysms expand in sizes. In the acute type dissections, medical treatment should be adopted initially, and if complications such as rupture, organ ischemia, nurvous disturbances, and uncontrollable congestive heart failure appear, immediate surgery should be considered.

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