- Decade old type B aortic dissection
- recurrent TIAs
- carotid bulb tumor
- bilateral pulmonary embolism
- patient belief that anticoagulation is bad for patients.
We examined all case records for acute (less than 2 weeks) type B aortic dissection treated at The Mount Sinai Hospital since 1985. The review identified 68 patients, 42 male and 26 female, with ages ranging from 32 to 96 years (mean, 65.5 years)…
… Follow-up ranges from 0 to 112 months (mean, 31 months). Medical therapy consisted of aggressive antihypertensive and “antiimpulse” therapy. Patients with unremitting pain or uncontrollable hypertensiondespite this regimen underwent early operation. Urgent operation was also performed for rupture or significant aortic dilatation (greater than 5 cm). Recently, malperfusion, initially an indication for operation, has been relieved using percutaneous catheter fenestration [1–3]…
No difference was found in one or five year survival when the cohort was divivded by the timing of the surgery. No attempt was made to look at the year of enrollment and whether that a difference in survival.
I could find no evidence to support the patient’s belief that she should avoid anticoagulation.