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.
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Bergdahl L, Bjork VO (1980) Management of dissecting aneurysms of the aorta. Scand J Thorac Cardiovasc Surg 14:91–95
Castaigne A, Binet J-P, Francoual M, Benhaiem N (1979) Dissections aortiques: Diagnostic et traitement. Rev Prat 29:751–762
Cipriano PR, Griepp RB (1979) Acute retrograde dissection of the ascending thoracic aorta. Am J Cardiol 43:520–528
Dalen JE, Howe JP (1979) Dissection of the aorta. Current diagnosis and therapeutic approaches. JAMA 242:1530–1532
De Bakey ME, Henly WS, Cooley DA, Morris GC, Crawford ES, Beall AC (1965) Surgical management of dissecting aneurysms of the aorta. J Thorac Cardiovasc Surg 49:130–148.
Dureau G, Villard J, George M, Deliry P, Froment J-C, Clermont A (1978) New surgical technique for the operative management of acute dissections of the ascending aorta. J Thorac Cardiovasc Surg 76:385–389
Escojido H, Salomon M, Bousquet J-P, Roux JJ, Boyer C, Rapuzzi A, Jouven J-C, Torresani J, Jouve A (1978) Aspects échocardiographiques des dissections aortiques. Ann Cardiol Angeiol (Paris) 27:263–266
Guillot M, Froment J-C, Touboul P, Delahaye J-P, Pinet F (1979) Dissections aortiques aigues. Facteurs pronostiques, indications thérapeutiques, 137 observations. Nouv Presse Med 8:2603–2607.
Guthaner DF, Miller DC, Silverman JF, Stinson EB, Wexler L (1979) Fate of the false lumen following surgical repair of aortic dissections: An angiographic study. Radiology 133:1–8.
Gutierrez FR, Gowda S, Ludbrook PA, McKnight RC (1980) Cineangiography in the diagnosis and evolution of aortic dissection. Radiology 135:759–761
Kieny R, Eisenmann B, Kretz JG, Baehrel B, Jeanblanc B, Kurtz T (1979) Les dissections aigues de l’aorte. A propos d’une série de 45 patients dont 29 opérés. Ann Chir (Chir Thorac Cardiovasc) 33:617–621
Mátsumoto M, Matsuo H, Ohara T, Yoshioka Y, Abe H (1978) A two-dimensional echoaortocardiographic approach to dissecting aneurysms of the aorta to prevent false-positive diagnoses. Radiology 127:491–499.
Miller DC, Stinson EB, Oyer PE, Rossiter SJ, Reitz BA, Griepp RB, Shumway NE (1979) Operative treatment of aortic dissections. Experience with 125 patients over a sixteen-year period. J Thorac Cardiovasc Surg 78:365–382
Mills SE, Teja K, Crosby IK, Sturgill BC (1979) Aortic dissection: Surgical and nonsurgical treatments compared. Am J Surg 137:240–243
Pinet F, Amiel M, Tran-Minh V, Froment J-C, Oulton C, Rubet A, Clermont A (1975) Emergency selective aortography for acute lesions of the thoracic aorta. Vasc Surg 2:162–169
Thomas CS, Alford WC, Burrus GR, Frist RA, Stoney WS (1978) The effectiveness of surgical treatment of acute aortic dissection. Ann Thorac Surg 26:42–49
Soyer R, D’Allaines C, Blondeau P, Piwnica A, Carpentier A, Deloche A, Lessana A, Brunet A, Dubost C (1979) Dissection aortiques aigues rompues dans le péricarde. A propos de 51 cas opérés. Ann Chir (Chir Thorac Cardiovasc) 33:628–631
Vecht RJ, Besterman EMM, Bromleyl LL, Eastcott HHG, Kenyon JR (1980) Acute dissection of the aorta. Long-term review and management. Lancet 8160:109–112
Wheat MW, Shumacker HB, Wakefield DL (1976) Dissecting aneurysms. Problems of management. Chest 70:650–655
Wheat MW (1980) Acute dissecting aneurysms of the aorta. Diagnosis and treatment — 1979. Am Heart J 99:373–387
Wolfe WG, Moran JF (1977) The evolution of medical and surgical management of acute aortic dissection (editorial). Circulation 56:503–505
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Pinet, F., Froment, J.C., Guillot, M. et al. Prognostic factors and indications for surgical treatment of acute aortic dissections: A report based on 191 observations. Cardiovasc Intervent Radiol 7, 257–266 (1984). https://doi.org/10.1007/BF02625108