Abstract
From January of 1987 to December 1992, twelve patients (7 males and 5 females, mean age, 52.8 years) underwent emergency surgery for DeBakey type I acute aortic dissection. The surgical procedure was resection of the initial intimal tear and replacement of the ascending aorta (four patients underwent hemiarch replacement). Operative mortality was 41.7% (5/12). Three died in the operating room due to heart failure (2) and uncontrollable bleeding (1). Another two early deaths resulted from extension of the residual false lumen. All surviving patients each had a patent double-channeled aorta and aneurysmal dilatation of the false lumen was noted in 3 patients. There were two late deaths, one due to rupture of the residual false lumen and the other, to stroke during re-operation for enlargement of the residual false lumen. It is apparent from these results that in type I acute aortic dissection extensive operation such as total arch replacement is necessary.
