Case of the Month #30 Aortic Dissection
What are the potential complications following open repair of the dissection?
Complications can arise from the dissection itself or from the procedure.
- From the primary dissection
- Short term comlications - cardiac tamponade, aortic incompetence and acute coronary syndrome, all of which would require surgical dissection repair.
- Longer term complications include aneurysmal degeneration and regional ischaemia.
- Secondary to the surgical repair
- Surgical repair can lead to stroke in up to 16% of cases, as well as spinal ischaemia, bowel ischaemia, renal failure and mediastinitis (8).
- Overall 10 year survival from hospitalisation is 30-60% (5). Mortality is classfication dependent; type A carries a 50% mortality if not operated on within 48 hours (1). Conversely, the 5 year survival after TEVAR for type B is 81% (7).
In this case, the patient was successfully stepped down and discharged from hospital.