Acute Aortic Disease.. - Index of

192 Coady and Elefteriades
another cause—angina, esophageal spasm, lumbosacral spine disease or the
like—we presume that the pain is of aortic origin. We know of no other way to
protect the patient from aortic rupture than to draw this conclusion.
It is taken as self-evident that age and coexisting disease may well render
aggressive surgical intervention inappropriate for some patients. Thus, each patient
must be evaluated independently, and anticipated risks of operation (especially
paraplegia with descending aortic aneurysms) weighed against the anticipated
risks of rupture and dissection. Moreover, the level of experience at the treating
medical center with these major surgical procedures must be taken into account.
The size criteria presented in this chapter are proposed for otherwise healthy
patients cared for at experienced centers.
CONCLUSION
The natural behavior of the thoracic aorta is increasingly being clarified, strengthening
the physician’s and surgeon’s position in the treatment of patients harboring
this virulent disease.
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