Prognosis

Ten year mortality rate in discharged patients is reported to be between 30% to 60% (1).

International Registry of Acute Dissection (IRAD) have noted that current overall in-hospital mortality rates

• for type A is 26% for surgically managed and 58% for medically managed patients (advanced age, comorbidities)
• for type B is 31.4% for surgically managed and 10.7% for medically managed patients (advanced age, comorbidities) (2)

The European Society of Cardiology recommends serial imaging of the aorta (preferably with MRI), at one, three, and 12 months after discharge and every six to 12 months thereafter, depending on aortic size (1)

Lifelong antihypertensive therapy with beta blockers should be given to all patients and the target blood pressure should be 120/80 mm Hg (1)

Reference:

• (1) Thrumurthy SG et al. The diagnosis and management of aortic dissection. BMJ. 2011;344:d8290.
• (2) Hebballi R, Swanevelder J. Diagnosis and management of aortic dissection. Contin Educ Anaesth Crit Care Pain (2009) 9 (1): 14-18