CTSN- Acute Aortic Dissection Refs

CTSN - Acute Aortic Dissection Selected References Acute Aortic Dissection References Selected Articles
Fann JI, Smith JA, Miller DC, Mitchell RS, Moore KA, Grunkmeier G, Stinson EB, Oyer PE, Reitz BA, Shumway NE. Surgical management of aortic dissection during a 30-year period. Circulation 1995 92(9 Suppl):II113-21.

This series of 360 patients covers surgical repair of both acute and chronic dissections. Operative mortality rates have remained essentially the same and long-term outcome remains fair.

Kitamura M, Hashimoto A, Akimoto T, Tagusari O, Aomi S, Koyanagi H. Operation for type A dissection: introduction of retrograde cerebral perfusion. Annals of Thoracic Surgery 1995 59(5):1195-9.

Kitamura M, Hashimoto A, Tagusari O, Akimoto T, Aomi S, Koyanagi H. Operation for type B aortic dissection: introduction of left heart bypass. Annals of Thoracic Surgery 1995 59(5):1200-3.

This pair of articles presents two modalities which may improve results for aortic dissection, as evidenced by actuarial survival analysis. 5-year survival was estimated at 92% for type A patients and 80% for type B patients.

Rizzo RJ, Aranki SF, Aklog L, Couper GS, Adams DH, Collins JJ Jr, Kinchla NM, Allred EN, Cohn LH. Rapid noninvasive diagnosis and surgical repair of acute ascending aortic dissection. Improved survival with less angiography. Journal of Thoracic and Cardiovascular Surgery 1994 108(3):567-74.

This paper compares evaluation using angiography and CT or echo; the second group of patients had lower mortality. Noninvasive means may expedite surgery and decrease the risk of rupture; the authors discuss the significance of coronary artery disease in these patients.

Crawford ES, Kirklin JW, Naftel DC, Svensson LG, Coselli JS, Safi HJ. Surgery for acute dissection of ascending aorta. Should the arch be included? Journal of Thoracic and Cardiovascular Surgery 1992 104(1):46-59.

In this statistical analysis of 82 patients, the authors compare survival with and without arch repair. Predicted 10 and 20 year survival was 61% and 39% without arch repair and 48% and 31% with arch repair.

Schor JS, Yerlioglu ME, Galla JD, Lansman SL, Ergin MA, Griepp RB. Selective management of acute type B aortic dissection: long-term follow-up. Annals of Thoracic Surgery 1996 61(5):1339-41.

This ten-year series of patients compares early operative intervention and nonoperative management of type B dissection. 5-year actuarial survival was 68% for the operative group and 87% for the nonoperative group.

Sources for further reading
Textbook Chapters
Chapter 33, Part IV:Thoracic Aortic Aneurysms and Aortic Dissection. Surgery of the Chest (Sabiston and Spencer), 5th ed., 1182-1209.

Chapter 53: Acute Traumatic Aortic Transection and Chapter 54: Acute Aortic Dissection. Cardiac Surgery (Kirklin and Barratt-Boyes), 2nd ed., 1701-1748.

Chapter 138: Dissections of the Aorta. Glenn's Thoracic and Cardiovascular Surgery (Baue, Geha, Hammond, Laks, and Naunheim), 6th ed., 2273-2298.

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