[HSF] Aortic dissection and CPR

[Jbflegejr at aol.com]

Percutaneous bypass in precense of severe AI isn't going to help and probably 
would do more damage. In my view the only way to salvage such a patient is to 
have him in the OR and on bypass before he collapses. Since one cannot 
predict which patient presenting with aortic dissection will suddenly collapse and 
the danger of sudden collapse is greatest early after the onset of dissection 
diminishing as time passes, it is imperative that such patients with acute Type 
A dissection be taken immediately to the OR after they present to the ER. 
Most institutions, including mine, are not prepared to start an open heart 
operation in a matter of minutes, so patients such as you describe will continue to 
die. John Flege



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