Delayed treatment for ascending aortic dissection should be considered:
Because of the risk of aortic rupture, acute ascending aortic dissection is usually considered an absolute indication for emergency surgical repair. However, specific patient groups may benefit from nonoperative management or delayed operation. Delayed repair should be considered for patients who (a) present with severe acute stroke or mesenteric ischemia, (b) are elderly and have substantial comorbidity, (c) are in stable condition and may benefit from transfer to specialized centers, or (d) have undergone a cardiac operation in the remote past. Regarding the last group, it is important that the previous operation not be too recent; dissections that occur during the first 3 weeks after cardiac surgery pose a high risk of rupture and tamponade, and such dissections warrant early operation.
A patient with a subclavian artery malperfusion as a complication of aortic dissection would most likely experience:
Anatomic complications of aortic dissection and their associated symptoms and signs:
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