Survey of operative outcome for aortic dissection

OBJECTIVE: To survey the results of operative outcome for aortic dissection.

METHODS: A retrospective study on 46 patients, admitted for operation in Shahid Madani Heart Hospital in Tabriz, Iran from 1994-2003. A questionnaire was used for collecting data. Statistical analysis was performed and was carried out through a descriptive statistical methods.

RESULTS: We included 30 males (65%) and 16 females (35%). Seven (15.2%) died in the operating room before surgery, while 39 patients (59% male and 41% female) underwent surgery. The mean age of patients was 48.9 ± 2.3 years old. Pre-operative diagnosis was carried out by transesophageal echocardiography and angiography. All patients were operated in an emergency situation. In 42% of patients aortic valve replacement (AVR) with ascending aorta was replaced. In 24% only the ascending aorta was replaced, and in 10% the aortic valve was repaired with acute aortic dissection. In 10% of patients, the ascending aorta with aortic arch was replaced. Four patients (14%) had distal aortic dissection and replacement. Major complications were hemorrhage (31%) and respiratory failure (13.8%). A total of 20.7% died in hospital, and only 21 patients (45.5%) could be followed for 10 years.

CONCLUSION: Acute aortic dissection is a fatal disease. With early diagnosis and surgical intervention, we can save approximately 75% of patients with very good functional class and survival in the mid term.