晕厥表现通常与较坏的治疗效果有关。也有报道一种低血压/休克(无晕厥)、无胸痛或背痛(可能与诊断延误相关)和分支血管受累的致命三联征。[34]Suzuki T, Mehta RH, Ince H, et al. Clinical profiles and outcomes of acute type B aortic dissection in the current era: lessons from the International Registry of Aortic Dissection (IRAD). Circulation. 2003;108(suppl II):II-312-II-317.http://circ.ahajournals.org/content/108/10_suppl_1/II-312.longhttp://www.ncbi.nlm.nih.gov/pubmed/12970252?tool=bestpractice.com
如果未经治疗,50% 至 60% 的患者 24 小时内近端急性主动脉夹层的自然病程为假通道破裂伴致命性出血。[29]Svensson LG, Kouchoukos NT, Miller DC, et al. Expert consensus document on the treatment of descending thoracic aortic disease using endovascular stent-grafts. Ann Thorac Surg. 2008;85(suppl 1):S1-S41.http://www.ncbi.nlm.nih.gov/pubmed/18083364?tool=bestpractice.com
30% 至 50% 的患者发生夹层主动脉晚期恶化成假腔动脉瘤。[7]Crawford ES. The diagnosis and management of aortic dissection. JAMA. 1990;264:2537-2541.http://www.ncbi.nlm.nih.gov/pubmed/2232021?tool=bestpractice.com治疗后,患者仍处于其余病变主动脉进一步动脉瘤样病变的风险中。
[Figure caption and citation for the preceding image starts]: 近端修复后的夹层状态伴晚期远端动脉瘤(图片)由 Eric E. Roselli 医生提供 [Citation ends].升主动脉夹层手术后的 10 年生存率为 52%。5 年和 10 年内免于再次手术的比例从 59% 至 95% 不等。[24]Subramanian S, Roselli EE. Thoracic aortic dissection: long-term results of endovascular and open repair. Semin Vasc Surg. 2009;22:61-68.http://www.ncbi.nlm.nih.gov/pubmed/19573743?tool=bestpractice.com