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Management remains a challengein elective as well as emergency cases. The decision whenand if to operate, based on the balance of surgical risk and hazardof aortic rupture, may be difficult in elective cases. With thoracicaortic rupture, on the other hand, mortality is exceedingly high,ie, 94% to 100%.1,2 When rupture is imminent, as in acuteproximal aortic dissection, outcome of surgical treatment interms of operative mortality and morbidity has not improvedsubstantially in the past decades despite the progress of medicaland surgical treatment3–5 and was recently reported by theInternational Registry of Aortic Dissection to be 25%.5
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