Follow-up after surgical treatment of acute aortic dissection type A Stanford

Abstract

Background Acute aortic dissection (AAD) is a fatal disease if early diagnosis and institution of appropriate therapy are delayed. For type A dissections, surgical repair is essential. The goal of this study is to summarize the diagnostic algorithm, long-term management regimen that offer patients with an acute aortic dissection the best chance for shortterm and long-term survival.
Material and methods 68 [50 males (78.5%) and 18 females (26.5%), mean age 48.1 ± 11 years] consecutive patients undergoing surgery for AAD in a 20-year period (1986-2006) were evaluated. In all patients computed tomography (CT) and doppler ultrasound examination were performed in the aim to analyze thoracic and abdomen aorta as well as following arteries: carotid arteries, brachiocephalic trunk, coeliac trunk, renal, mesenteric and iliac arteries.
Results Hypertension was observed in 51 patients (75%). Chronic dissection of the arch and descendent aorta was present in 44 patients (64.7%), in abdominal aorta in 40 patients (58.8%). 10 patients (14.7%) required surgical retreatment, 5 patients (7.4%) underwent endovascular stent-graft repair of the thoracic and abdomen aorta. There were 4 (5.9%) late deaths. At 10 years survival was 92,6%.
Conclusion Long-term mortality in our series was low. Patients after surgical treatment of acute aortic dissection type A require very close follow-up and a plan for retreatment to prevent sudden aortic rupture and late death.