Acute aortic dissections. Hospital outcome of 186 cases
Vianna, C.de.B.; Barretto, A.C.; Cesar, L.A.; Mady, C.; Stolf, N.; Bellotti, G.; Jatene, A.D.; Pileggi, F.
Arquivos Brasileiros de Cardiologia 58(2): 95-99
1992
ISSN/ISBN: 0066-782X PMID: 1307465 Document Number: 398455
To determine in hospital outcome acute aortic dissection patients. We revised 186 consecutive cases (up to 14 days of dissection), in a period of 6 years. The patients were divided according to Daily's classification (types A and B). Type A--127 cases: a) 75 were surgically treated (37 died); b) 2 were medically treated (both died); c) 39 died before the definitive treatment could be initiated; d) 11 died misdiagnosed or undiagnosed. The total mortality was 70.0%. Type B--59 cases: a) 11 complicated cases were surgically treated (6 died); b) 40 were medically treated (8 died); c) 7 died before the definitive treatment could be initiated; d) one died misdiagnosed. The total mortality was 37.25%. In summary, 41.4% of the patients survived. 28.4% died despite the definitive treatment, 24.7% died before the definitive treatment could be initiated and 6.4% died without the correct diagnosis. The acute aortic dissection is a dramatic situation, mainly type A. In this type of dissection many patients (41%) died misdiagnosed, undiagnosed or without enough time to surgical therapy. So, an earlier diagnosis and treatment are imperative.