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[Causes of failure in surgical treatment of acute dissection of the ascending aorta (type A)].

In 27 patients with acute dissection of the ascending aorta where during 1988-1995 for reconstruction of the affected portion of the aorta an intraluminal prosthesis was used, a retrospective analysis of some factors was made to evaluate their importance for the final result of the operation. The analysis proved the fundamental importance of complications present before operation. Among them, in association with the extent of the dissection, the most important one proved to be cardiac tamponade, impaired renal function and a state of shock. More detailed analysis revealed the unequivocal relationship of the development of these complications with the protracting time interval between the development of the dissection and the surgical operation. Because symptoms of dissection of the thoracic aorta are very closed to clinical manifestations of AIM, it is useful, if the latter is ruled out, to consider this possibility and focus the further procedures on the most rapid possible confirmation or at least justified suspicion of this disease and to contact without delay a cardiosurgical department. Only in this way we can improve the results which so far do not correspond the possibilities of surgical and anaesthesiological care.