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THE JOURNAL OF CARDIOVASCULAR SURGERY
A Journal on Cardiac, Vascular and Thoracic Surgery
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,632
THE MANAGEMENT OF THORACIC DISSECTIONS
The Journal of Cardiovascular Surgery 2011 August;52(4):519-27
Uncomplicated type B dissection: are there any indications for early intervention?
De Rango P. 1, Estrera A. L. 2 ✉
1 Vascular Endovascular Surgery, Hospital S. M. Misericordia, University of Perugia, Perugia, Italy;
2 Cardiothoracic and Vascular Surgery, University of Texas Medical School Houston, Memorial Hermann Heart and Vascular Institute, Houston, TX, USA
Currently thoracic endovascular repair (TEVAR) has a limited role in uncomplicated type B aortic dissection. Aggressive medical therapy is deemed appropriate for most of these patients allowing one-year survival rate of 80-90%. Outcomes are less than optimal in the long term, however, since aorta related complications (disease progression, rapid deterioration, acute rupture and elevated mortality) may occur in up to 50% of patients at five years. Subgroups of patients with uncomplicated type B dissection may benefit from early stent-graft placement, but identification of these remains difficult. Only future studies, especially randomized trials, will clarify the utility of early TEVAR in the setting of uncomplicated acute type B dissection.