Type B Aorta Dissection longterm prognosis

My 63 year-old husband had a type b aortic dissection on April 11, 2008.  He is being medically treated with Bystolic 10mg in the evening and Lisenopril 20 mg taken in the morning.  He was switched from Metoprolol XL 50mg to the Bystolic this week.



He had a CT Angiogram Thoracic Aorta recently.  The results of that report are as follow:



Technique:  The patient underwent angiography on a Philips Brilliance 64 slice CT Scanner.  The patient was imaged from the aortic arch to the diaphragm.  Advanced 2D and 3D post-processing was done on the workstation.  This study focuses solely on the vascular structures.



Interpretation:  There is a focal, saccular dissection of the distal thoracic aorta at the diaphragmatic hiatus, extending into the proximal abdominal aorta.  The dissection is exclusively anterior and measures 4.6 cm in greatest dimension (cephalad to caudad) and is approximately 2.0 cm in greatest AP diameter.  The A-P diameter of the aorta at l level is 3.7 cm.  The dissection terminates just cephalad to the celiac artery.  The spinal arteries arise off the true lumen.



Impression

Stable, focal, saccular, distal thoraco-abdominal dissection (type b).  The spinal arteries arise off the true lumen and the dissection terminates just cephalad to the celiac artery.  These findings are essentially unchanged from 5/08.


I stay in constant fear for him.  Although I’ve asked many questions about the longterm outlook for my husband, I still don’t feel that I’m anymore knowledgeable about his condition that when we started.  Can you help us?

[Darcy Green Conaway, MD]

I have put a pretty good website below for you to look through. It seems to me that the aneurysm is stable. Just make sure you have someone following it closely and treating his blood pressure aggressively. Good luck on your reading



http://www.sts.org/sections/patientinformation/aneurysmsurgery/aorticaneurysms/