DISECCION AORTICA PDF

Treatment Aortic dissection is a life-threatening condition and needs to be treated right away. Dissections that occur in the part of the aorta that is leaving the heart ascending are treated with surgery. Dissections that occur in other parts of the aorta descending may be managed with surgery or medicines. Two techniques may be used for surgery: Standard, open surgery.

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Dosida Disadvantages include the need for iodinated aortida material and the inability to diagnose the site of the intimal tear. The cause of the infarction is involvement of the coronary arterieswhich supply the heart with oxygenated blood, in the dissection. It has become the preferred disecxion modality for suspected aortic dissection. Surgery for aortic dissection was first introduced and developed by Michael E.

The target blood pressure should be a mean arterial pressure MAP of 60 to 75 mmHgor the lowest blood pressure tolerated. Chest CT with descending type B Stanford aortic dissection red circle. Diseases of the aorta Diseases of arteries, arterioles and capillaries Deaths from aortic dissection Causes of death Medical emergencies Vascular surgery IgG4-related disease.

The calcium channel blockers typically used are verapamil and diltiazembecause of their combined vasodilator and negative inotropic effects. The relative risk of late rupture of an aortic aneurysm is 10 times higher in individuals who have uncontrolled hypertension, compared to individuals with a systolic pressure below mmHg.

CT with contrast demonstrating aneurysmal dilation and a dissection of the ascending aorta type A Stanford. The valve must be resuspended in order to be reseated, as well as to repair or prevent coronary artery injury. Anterograde dissections may propagate all the way to the iliac bifurcation of the aorta, rupture the aortic wall, or recanalize into the intravascular lumen leading to a double-barrel aorta.

The scan then follows the contrast as it flows through the vessel. Archived from the original on 9 May Chest trauma leading to aortic dissection can be divided into two groups based on cause: These individuals are prone to dissection in the ascending aorta. J Thorac Cardiovasc Surg. Indications for the surgical treatment of aortic dissection include an acute proximal aortic dissection and an acute distal aortic dissection with one or more complications.

In this subset, the incidence in young individuals is increased. The double-barrel aorta relieves the pressure of blood flow and reduces the risk of rupture. The third mechanism is that if there was an extensive intimal tear, the intimal flap may prolapse into the Diseccin outflow tract, causing intimal intussusception into the aortic valve preventing proper valve closure. The particular treatment used depends on the segment or segments of aorta involved. Aortic dissection Acute infrarenal abdominal aortic dissection.

The reason for surgical repair of type A dissections is that ascending aortic dissections often involve the aortic valve, which, having lost its suspensory support, telescopes down into the aortic root, resulting in aortic incompetence.

While the pain may be confused with the pain of a myocardial infarction heart attackaortic dissection is usually not associated with the other signs that suggest myocardial infarction, including heart failure and ECG disefcion. For Stanford type A ascending aortic dissection, surgical management is superior to medical management. A number of comorbid conditions increase the surgical risk of repair of an aortic dissection.

Archived from the original on 24 December An MRI examination of the aorta produces a three-dimensional reconstruction of the aorta, allowing the physician to determine the location of the intimal tear and the involvement of branch vessels, and to locate any secondary tears.

If there is high clinical suspicion, a more sensitive imaging test CT angiogramMR angiographyor transesophageal echo may be warranted. There was a problem providing the content you requested DeBakeyis an anatomical description of the aortic dissection. In the image to the left, the intimal flap can be seen separating the two lumens. Vasodilators such as sodium nitroprusside can be considered for people with ongoing high blood pressure, but they should never be used alone, as they often stimulate a reflexive increase in the heart rate.

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