Surgical Treatment of Dissecting Aneurysm of the Aorta Analysis of Seventy-Two Cases

Abstract

Dissecting aneurysm of the aorta is an extremely serious condition that pursues a rapidly fatal course in more than 75 per cent of cases. Follow-up data on 72 patients surgically treated indicate that effective surgical treatment significantly alters the course of the disease and in the majority of instances removes the threat of death by rupture. The operative mortality rate in these 72 patients was 26 per cent. For lesions occurring distal to the left subclavian artery, resection of the descending thoracic aorta with replacement by aortic graft utilizing hypothermia or the bypass pump was successful in 80 per cent of cases. Most patients surviving operation have been able to resume previous activities with minimal risk of sudden death from rupture of the aneurysm or failure of the aortic graft. The importance of recognizing the characteristic clinical manifestations, of making precise roentgenographic diagnosis, and of instituting effective surgical treatment in the management of dissecting aortic aneurysm has been stressed.