Prognosis of Stanford Type B Acute Aortic Dissection and Availability of Early Rehabilitation Program in Medical Treatment.
10.4326/jjcvs.31.114
- VernacularTitle:Ｓｔａｎｆｏｒｄ Ｂ型急性大動脈解離の急性期治療成績と保存療法における早期離床の有用性
- Author:
Hitoshi Fukumoto
;
Yasuhisa Nishimoto
;
Masayoshi Nishimoto
;
Toshihiko Ibaragi
;
Shuuichi Suzuki
;
Akira Fujiwara
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
2002;31(2):114-119
- CountryJapan
- Language:Japanese
-
Abstract:
Stanford type B acute aortic dissection without complications has been considered to be an indication for medical rather than surgical treatment. To investigate the availability of medical treatment and early rehabilitation, we evaluated 90 cases treated between 1986 and 1999 with type B acute aortic dissection. These consisted of 79 nonruptured cases and 11 ruptured cases at the beginning of treatment in our medical center. No surgery was performed in any of the nonruptured cases but surgery was performed in 8 of 11 ruptured cases. Surgical mortality in the rupture type was 12.5% (1/8). During medical treatment of the nonrupture type, 3 patients died of sudden rupture (1 case) and bowel ischemia (2 cases). An early rehabilitation program in which the goal was for the patient to walk around the ward within 2 weeks was performed for 31 consecutive cases of nonrupture type without vascular complications. Mortality was not significantly different between the early and conventional rehabilitation groups. The incidence of pneumonia and ICU syndrome during medical treatment was 13.0% (6/46) and 37% (17/46), respectively in the conventional group and 0% and 12.9% (4/31), respectively in the early group. The incidence of ICU syndrome was significantly lower in the early group than in the conventional group. Despite the limitations of this study, medical treatment and early rehabilitation showed good results in cases of uncomplicated type B acute aortic dissection.
