Successful medical management of a 16-month chronic type A aortic dissection.

Stanford type A dissections usually require surgery because they are associated with high morbidity and mortality. However, there are situations where medical management becomes the definitive treatment. We report the successful medical management of a 16-month chronic type A aortic dissection in a 56-year-old male patient with a past surgical history of ascending aortic aneurysm repair. The dissection is unique because it is distal to the graft and does not extend into the main aortic branches. A review of a patient's surgical history and nonenhanced imaging studies is essential when a type A dissection is discovered. Ascending aortic grafts may preclude the most serious complications of type A dissections.