Aortic dissection occurs due to shearing stress from pulsatile pressure causing a tear in the tunica intima of the aortic wall. This tear allows blood to flow into the media, creating a “false lumen.” Aortic dissection is most commonly caused by uncontrolled hypertension. Complications arise due to partial occlusion of vital branches off the aorta and reduced blood flow to the brain, visceral organs, and extremities. Patients often present with acute, tearing chest or back pain. Computed tomography is the diagnostic modality of choice. All type A dissections (ascending aorta) are a surgical emergency due to the risk of imminent rupture. Type B dissections (descending aorta) can be managed medically with impulse control using beta-blockers and calcium channel blockers. If there is evidence of malperfusion to visceral organs or extremities, aneurysm dilation to > 5 cm, retrograde extension into the ascending aorta, or intractable pain, the patient will need evaluation for endovascular or open repair.
Last updated: Dec 5, 2022
Type A dissections require emergent surgical intervention for replacement of the involved ascending aorta Aorta The main trunk of the systemic arteries. Mediastinum and Great Vessels: Anatomy or the entire ascending aorta Aorta The main trunk of the systemic arteries. Mediastinum and Great Vessels: Anatomy with Dacron graft Graft A piece of living tissue that is surgically transplanted Organ Transplantation.
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