From the Guidelines
The survival rate for ascending aorta rupture is extremely low, with mortality rates exceeding 50% by 1 month after presentation, and early mortality rates are reported to be 1% to 2% per hour after the onset of symptoms for untreated ascending aortic dissection 1. Without immediate surgical intervention, death typically occurs within minutes to hours after rupture due to massive internal bleeding and cardiac tamponade. Even with prompt emergency surgery, the survival rate remains poor, with medical management of acute ascending aortic dissection associated with a mortality rate of nearly 20% by 24 hours after presentation, 30% by 48 hours, 40% to 70% by day 7, and 50% by 1 month 1. Some key factors that influence survival include:
- How quickly the patient receives medical attention
- The extent of the rupture
- The patient's age and overall health status
- Whether the rupture occurs in a hospital setting where immediate surgical intervention is possible The high mortality rate is due to the aorta's role as the main artery carrying blood from the heart, with ruptures causing catastrophic blood loss at a rate that cannot be compensated for without immediate surgical repair. Patients who do survive require intensive care management and face potential complications including stroke, kidney failure, and long-term cardiovascular issues. Given the high mortality rate associated with ascending aorta rupture, prompt surgical intervention is crucial to improve survival rates.
From the Research
Survival Rate for Ascending Aorta Rupture
- The survival rate for ascending aorta rupture is not explicitly stated in the provided studies, but the mortality rates for endovascular repair of ascending aortic pathologies can be found in several studies 2, 3, 4, 5.
- A study published in 2018 reported an all-cause mortality rate of 15.2% and an aorta-related mortality rate of 5% for endovascular repair of ascending aortic diseases 4.
- Another study published in 2015 reported zero in-hospital and 30-day mortalities for endovascular repair of ascending aortic pathologies in patients at high risk for open repair 3.
- A case series published in 2024 reported that all three patients who underwent endovascular repair of ascending aortic pathologies were alive at 2 years of follow-up, with one patient requiring reintervention for a type Ia endoleak 5.
- The studies suggest that endovascular repair of ascending aortic pathologies can be a life-saving procedure for patients who are at high risk for open repair, but the survival rate may vary depending on the specific disease, patient characteristics, and treatment approach 2, 3, 4, 5.