Optimal treatment of type B acute aortic dissection: long-term medical follow-up results

Prognosis for Patients With Type B Acute Aortic Dissection Risk Analysis of Early Death and Requirement for Elective Surgery

“…6 Midterm survival of BAD patients should be more favorable with aggressive hypotensive treatment and close monitoring by a cardiologist or cardiovascular surgeon. 1 The present study showed a greater than 80% chance of survival after 5 years. We speculate that there are 2 important determinants of successful long-term outcome, namely the identification and care of patients at risk of early death, and the management of those in the early phase in order to avoid elective surgery.…”

“…1,6 However, some patients die in hospital from these causes, while others have large aneurysms requiring extensive operations. 7,8 The hospital mortality rate of patients undergoing surgical treatment for BAD is still very high, 9 and although minimally invasive endovascular approaches have been developed, this treatment also carries a relatively high rate of complications and death.…”

Editor's Choice – Management of Descending Thoracic Aorta Diseases

“…The expansion rate of the chronically dissected aorta is not well known but ranges between 1 and 7 mm per year. 171 Hypertension, an aortic diameter of 40 mm or more in the acute phase, chronic obstructive pulmonary disease, and patency of the FL have been recognized as risk factors for late aneurysmal degeneration. 169 In addition, the presence of an entry tear larger than 10 mm in diameter or located in the arch or proximal DTA has been recognized as a predictor of late mortality and the consequent need for aortic repair.…”

Role of Interventional Treatment of Thoracic Aorta

“…Estimates suggest that nearly one-third of patients surviving an acute dissection of the thoracic aorta will either experience complications like extension of the dissection and late aortic rupture or require surgical correction of a newly formed aortic aneurysm, within 5 years of initial presentation [29]. All patients merit aggressive medical therapy, follow-up visits, and serial CT-imaging.…”