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Prognostic factors and indications for surgical treatment of acute aortic dissections: A report based on 191 observations
Authors:François Pinet  Jean Claude Froment  Marcel Guillot  Yves Gourdol  Pascale Meyer  Robert Loire  Paul Touboul  Jean-Pierre Delahaye  Albert Biron  Philippe Messy
Affiliation:1. Service de Radiologie, France
3. Service de Soins Intensifs, France
4. Laboratoire d’Anatomie Pathologique, France
5. Ingenicurs au Département Informatique des Hospices Civils de Lyon Hospital Cardio-Vasculaire et Pneumologique Louis Pradel, Lyon, France
Abstract:A total of 191 acute aortic dissections were examined to define prognostic factors for surgical intervention. Overall survival rate reached 40% in the 94 patients operated upon and 8% in the 97 patients not operated upon. Among the 122 patients with involved ascending aorta, survival rate was 2% in the 42 nonoperated patients versus 42% in 80 patients undergoing surgery. Since 1977, overall survival rate has reached 60% in the surgical group (21 of 35 patients and 20% in the nonsurgical group (5 of 25 patients). Factors that showed a significant correlation with postoperative death include: (1) persistent shock; (2) persistent anuria; (3) persistent neurologic deficit; (4) diffuse intravascular coagulation; and (5) involvement of either the celiac trunk, superior mesenteric artery. or both renal arteries at angiography. With the exception of those patients exhibiting any of these high-risk factors, emergency surgical treatment is recommended for all dissections that involve the ascending aorta.
Keywords:Aorta  Acute dissection  aortic  Aortography  aortic dissection  Surgery  complications
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