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Acute Dissecting Aneurysm of the Aorta:  Diagnosis and Selection of Patients for Surgery

JULIAN R. BECKWITH, M.D.; WILLIAM H. MULLER, M.D.; W. DEAN WARREN, M.D.; J. EDWIN WOOD JR., M.D.
AMA Arch Intern Med. 1959;104(2):217-225. doi:10.1001/archinte.1959.00270080043005.
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The clinical diagnosis of acute dissecting aneurysm of the aorta has become increasingly important since a method of surgical treatment has been devised and successfully employed.1-4

Prior to this, a diagnosis was valuable chiefly for differentiation from other conditions. Diagnosis has always been important prognostically, however, since the mortality of untreated dissecting aneurysm is considerably more than most of the conditions with which it is confused. The clinical picture of acute dissecting aneurysm is protean in its manifestations and may mimic many other conditions. There have been a number of reviews and case reports describing it.*

Since the spontaneous cure of dissecting aneurysm is accomplished by the reentry of the dissecting column of blood into the lumen of the aorta, thus producing a doublebarreled aorta,23 surgical treatment was initially devised to accomplish this deliberately. This was done with the hope that the pressure in the false lumen would

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