XXXX for acute complicated type B aortic dissection: superiority relative to conventional open surgical and medical therapy.

@entity1 @entity2334
OBJECTIVE: This study compared outcomes between thoracic endovascular aortic repair and conventional open surgical and medical therapies for acute complicated type B aortic dissection. METHODS: From 2002 to 2010, a total of 170 @entity1 with type B aortic dissections were retrospectively identified from the University of Pennsylvania aortic database. Of these 170 @entity1 , 147 had acute type B aortic dissections (uncomplicated 70, complicated 77). For @entity1 with acute complicated type B aortic dissections, management included thoracic endovascular aortic repair (group A) or conventional open surgical and medical therapies (group B). RESULTS: In the 77 @entity1 with acute complicated type B aortic dissections, thoracic endovascular aortic repair (group A) was performed in 45 @entity1 (59%). In group B, 20 @entity1 (26%) underwent open surgical repair and 12 (15%) had their conditions managed with medical therapy. @entity2334 was associated with lower in-hospital or 30-day mortality (n = 2, 4%) than conventional therapy (open surgical repair n = 8, 40%, medical therapy, n = 4, 33%, P = .006). @entity1 in group A (thoracic endovascular aortic repair) continued to show significantly improved survival at 1, 3, and 5 years (group A: 82%, 79%, and 79% vs group B: 58%, 52%, and 44%, P = .008). CONCLUSIONS: @entity2334 for acute complicated type B dissection is associated with superior early outcome and improved midterm survival relative to conventional therapy. Longer follow-up demonstrating survival benefit is needed before definitive conclusion can be made.
