Natural history following dissection

Without surgery, approximately 40 per cent of ascending aortic dissections are fatal within 24 h and only 30 per cent survive 1 week; 86 per cent of these deaths are due to aortic rupture. Ten per cent of patients will survive for 3 months. Survival is higher in dissections limited to the descending aorta: 10 to 20 per cent will die within the first 24 to 48 h, 75 per cent will survive for 1 month, and over 60 per cent will survive for 1 year. Descending aortic dissection tends to occur in an older age group, and much of the mortality is not directly related to the dissection.

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