Acute dissecting aortic aneurysm: community hospital experience in 20 cases.

Of 20 patients with dissecting aortic aneurysm managed at our community hospital, 16 had type A (ascending) dissection and four had type B (descending) dissection. Twelve of the patients with type A dissection were operated on; six of them survived and six died postoperatively. The remaining four patients with type A dissection had cardiopulmonary arrest and died before surgical intervention was attempted. All four patients with type B dissection were treated medically and all survived. Although acute aortic dissection is not commonly seen at community hospitals, expedient management of such patients can have a major impact on their survival. Patients at extreme risk are those with type A dissection, particularly those with cardiopulmonary arrest.