OUTCOME OF MEDICALLY TREATED STANFORD TYPE-B AORTIC DISSECTION

Optimal treatment for patients with uncomplicated type B dissection re mains a matter of debate. From January, 1987, through June, 1996, 43 p atients with acute type B dissection were treated exclusively by medic al therapy according to our management guidelines, After discharge, ao rtography and enhanced computed tomography were performed every 6 mont hs to evaluate the diameter of the dissected aorta, All 43 patients su rvived the acute phase and were discharged alive from the hospital. Th ere was no death related to aortic dissection. Three patients underwen t surgical treatment in the chronic phase because of aortic enlargemen t. Aortic enlargement in 3 additional patients was managed medically, The values for freedom from aortic enlargement for 43 patients at 1, 3 , and 5 years were 100%, 91% and 86%, respectively. The long-term surv ival rates of patients treated medically and discharged from the hospi tal are acceptable.