Clinical outcome of emergency surgery for complicated acute type B aortic dissection

Takashi Murashita, Hitoshi Ogino, Hitoshi Matsuda, Hiroaki Sasaki, Hiroshi Tanaka, Yutaka Iba, Keitaro Domae, Tatsuki Fujiwara

Research output: Contribution to journalReview articlepeer-review

17 Scopus citations


Background: The aim of the present study was to review the clinical profile and outcome of emergency surgery for complicated acute type B aortic dissection. Methods and Results: A total of 34 consecutive patients requiring surgical treatment for complicated acute type B aortic dissection between 2003 and 2010 were examined. The median age was 64.0 years (range, 19-82 years). Indication for emergency surgery was aortic rupture in 11 patients, rapid expansion of the dissecting aorta in 5, dissection involving a non-dissecting aneurysm in 6, and organ malperfusion in 12. All of 3 patients with open aortic rupture died during surgery. Operative mortality was 9.7% (central operation, 14.2%; peripheral operation, 7.1%; thoracic endovascular aneurysm repair, 0%). There were 2 aortic ruptures within 1 week after operation. Two patients suffered from persistent organ malperfusion after emergency surgical relief of ischemia and died. The 1- and 5-year survival rates were 74.1±8.1% and 64.8±11.2%. The actual rate of freedom from aortic events at 1- and 5- years was 83.0±7.0% and 58.7±11.4%. Conclusions: Emergency surgery for complicated acute type B dissection still has a high mortality rate for patients with open rupture and critical visceral ischemia. Medical treatment is best given immediately after admission, and adequate surgical treatment without delay is crucial.

Original languageEnglish
Pages (from-to)650-654
Number of pages5
JournalCirculation Journal
Issue number3
StatePublished - 2012


  • Acute type B aortic dissection
  • Clinical outcome
  • Complicated aortic dissection
  • Open surgical treatment


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