Surgical treatment for acute aortic dissection and coexistent aortic aneurysm

Acute aortic dissection occurring in an aorta previously afflicted with degenerative, atherosclerotic is unusual. We report three cases with acute aortic dissection (DeBakey type III-b) occurring in an aorta which had a preexistent degenerative aortic aneurysm. Two of the three patients had acute aortic dissection originating from the distal end of the degenerative aneurysm, and the remaining one had the acute aortic dissection and degener- ative aneurysm at different segments of the aorta. Since the risk of rupture is likely to be much higher in the pa- tients with coexistence of acute aortic dissection and degenerative aortic aneurysm, compared with patients with DeBakey type III acute aortic dissection alone, we believe that a prompt and aggressive surgical approach is es- sential to prevent rupture, and that digital subtraction angiography (DSA) is more helpful in making a correct diagnosis and in helping to decide surgical procedures and supportive methods than other noninvasive diagnos- tic procedures. (Eur J Cardio-thorac Surg (1994) 8:616-6181