Outlook of Non Operated Type B Aortic Dissection with Special Reference to the Incidence of Degenerative Abdominal Aortic Aneurysm (AAA). One Center Study

Abstract

Objectives: to determine the value of pharmacological treatment of type B aortic dissection (B AD) in face of new forms of treatment.

Design: this is a retrospective study of the period from 1990 to 2000. Files of 81 patients have been reviewed and completed by questionnaires.

Results: Two B AD died after admission without any treatment, 10 were operated on with 7 discharged alive (group I); 69 received hypotensive agents and ß-blockers, 65 were discharged alive (group II). Late mortality of the group I is 3/7, not related with B AD. Late mortality after mean follow-up of 56.8 months is 27/65 with 4/27 related to B AD (4 ruptures, 2 operated on). Non fatal secondary surgery amounts 5 in 4 patients. Total B AD aortic events comprise 8/65 patients. Type A AD were operated on successfully (8: 4 before B AD, and 4 after B AD). Degenerative abdominal aortic aneurysms were present, operated (9) or not (3), in the history of patients and 3 more appear subsequently. At 10 years, actuarial survival is 40% ±18.

Conclusion: in non-complicated cases of B AD, medical treatment is a reasonable choice, provided that a strict follow-up of the thoracic abdominal aorta is performed.

Key Words:

• Dissecting aortic aneurysms
• abdominal aortic aneurysms
• thoracic aorta

Additional information

Notes on contributors

R. Limet

R. Limet Department of Cardiovascular and Thoracic Surgery University Hospital of Liège, CHU du Sart-Tilman 4000 Liège, Belgium Tel.: [phone] Fax: [phone] E-mail: [email protected]