European Journal of Cardio-Thoracic Surgery, Vol 8, 616-618, Copyright © 1994 by European Association for Cardio-thoracic Surgery
Surgical treatment for acute aortic dissection and coexistent degenerative aortic aneurysm. Report of three cases
S Aoyagi, H Akashi, Y Hanamoto, Y Higa, K Tayama, T Fujino, A Oryoji, K Kosuga and K Oishi
Second Department of Surgery, Kurume University School of Medicine, Japan.
Acute aortic dissection occurring in an aorta previously afflicted with
degenerative, atherosclerotic is unusual. We report three cases with acute
aortic dissection (DeBakey type III-b) occurring in an aorta which had a
preexistent degenerative aortic aneurysm. Two of the three patients had
acute aortic dissection originating from the distal end of the degenerative
aneurysm, and the remaining one had the acute aortic dissection and
degenerative aneurysm at different segments of the aorta. Since the risk of
rupture is likely to be much higher in the patients with coexistence of
acute aortic dissection and degenerative aortic aneurysm, compared with
patients with DeBakey type III acute aortic dissection alone, we believe
that a prompt and aggressive surgical approach is essential to prevent
rupture, and that digital subtraction angiography (DSA) is more helpful in
making a correct diagnosis and in helping to decide surgical procedures and
supportive methods than other noninvasive diagnostic procedures.
