A 98-year-old female. Eight years ago (at the age of 90), she was examined to another
hospital with sudden dyspnea feeling and back pain. She was hospitalized for diagnosis
of heart failure. After 1 week, echocardiography showed pericardial effusion. So she
was transferred to our hospital. A marked dilatation of the aorta was recognized.
It was proved the type A aortic dissection by contrast CT. The ascending aorta diameter
was 60 × 58 mm. It was usually indication for surgical treatment. But she was too
old. It was thrombosed type aortic dissection, and had passed one week since onset.
From these things, we performed conservative treatment for only heart failure. About
50 days later, she was discharged home. After that, she passed without any symptoms.
She was able to walk around her house. She was hospitalized due to congestive heart
failure 8 years later. The ascending aorta dilated to 85 × 72 mm with severe aortic
regurgitation. She gradually became worse and passed away for the 27th sick day. Type
A aortic dissection is a fatal disease that becomes an indication for emergency surgery.
But surgery has risks. Elderly person has many risks, and may have to choose conservative
treatment. We will report the case with no event for 8 years.
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