Acute aortic dissection.

Acute aortic dissection is the most lethal complication affecting the aorta. The use of two-dimensional echocardiography and computed tomography has greatly expanded the physician's ability to establish this diagnosis through noninvasive techniques. Surgery is the definitive treatment for type I and II dissection, whereas medical management with drugs that reduce cardiac output remains the treatment of choice in type III dissection. With improvements in surgical techniques, including cardiopulmonary bypass and composite grafting, immediate and long-term morbidity and mortality have been significantly reduced.