[The dissecting of aortic aneurysm].

In the light of the literature and a critical analysis of the author's own results, guidelines for therapy of aortic dissection from the surgical viewpoint are recommended. In cases of dissection of the ascending aorta, surgery should be performed as soon as possible. Only in special cases without complications can surgery be delayed with pump team standby. In uncomplicated cases of dissection of the descending thoracic aorta, medical therapy appears to be the method of choice. Some life-threatening situations render surgery inevitable. Surgical treatment of dissection of the aortic arch is indicated only on an ultima ratio basis.