Aortic Dissections of ascending aorta: outcome for operative survivors

pp 23-28

Abstract

This is a review of long term follow up and out- come for operative survivors with aortic dissections of ascending aorta (ADAA). In the period July 1971-July 1986, a group of un selected and consecutive 122 patients underwent operative repair. 83 patients survived and were classified according to the time of treatment in: acute (less than 15 days) (A), n =46, and chronic (C), n =37. The actuarial survival curves were of 91 t.4% at 60 months and 57t.16% at 120 months. Clinical preoperative characteristics: both groups (A) and (C) were analized and no statistically significant differences were found (age, sex, angina, myocardial infarction, aortic regurgitation, ischemic limb, shock and previous cardiac surgery). Except in (A) cerebral vascular accident (CVI) (p=0.03) and (C) Marfan's Syndrome (p =0.02). Operative features: tamponades, intimal tear resected, aortic segments involved, had no statistically signifi- cant bearing in a follow up. Incidence of late reoperation (dissection related) was 7/83 (8.4 %) (A) 2/46 (43 %), (C) 5/37 (13.5%) (p = NS). Late mortality in (C) was statistically significant when AVR" was performed 6/11 (p=O.OJ), 3/6 deaths were related with _a valvular prosthesis. Follow up (months): (A) X 36 (26-101), X 36.9; (C) X 36 (1-150), X 50.6. In general operative survivors showed satisfactory functional benefit. Incidence of late re operations, in our experience, did not show significant differences among the variables analized.