Abstract
It is widely accepted that primary management for uncomplicated acute type B dissection is medication. Consequently, emergency surgical treatment has been limited for complicated acute type B dissection, including aortic rupture or clinical organ malperfusion caused by aortic branch compromise. The optimal treatment for complicated acute aortic dissection, however, remains controversial. We treated 132 patients of type B aortic dissection for 25 years in our institution. Twenty-one patients (15.9%) required emergency operation for complication. Hospital mortality rate of emergency operation for complicated type B aortic dissection was 33.3%. Sixty-seven patients (59.8%) required operation during follow-up period. Overall operative mortality rate of operation at chronic stage was 6.0%. It is important to improve surgical outcomes for complicated acute type B aortic dissection. Thoracic endovascular aneurysm repair could be reducing the invasive damage, especially in acute rupture cases. Visceral ischemia is a rare but severe complication of an aortic dissection, unusually due to obliteration of visceral arteries by the intimal flap. We believe that rapid revascularization is the best way to treat visceral malperfusion syndrome.
