Aortic dissection resident survival guide

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Chetan Lokhande, M.B.B.S [2]

Definition

A tear in the layers of the aorta especially in the intima leading to bleeding and separation of the layers of the aorta from within which creates a false lumen.

Classification

DeBakey and Daily (Stanford) systems are the two types of systems used to classify aortic dissection.[1][2][3][4]

  • Stanford system classifies dissection into the following two types.
  1. Ascending aortic dissection or type A
  2. All other dissections or type B
  • DeBakey system classifies dissection according to location of the tear.
  1. Type 1- Starts at ascending aorta and extension upto the aortic arch.
  2. Type 2- Starts and is limited till the ascending aorta
  3. Type 3- Starts in the descending aorta and progresses proximally or distally.
  • The third type of classification divides aortic dissection according to the proximity
  1. Proximal- Ascending aortic involvement
  2. Distal- Descending aortic involvement distal to left subclavian artery.

Causes

Life Threatening Causes

Common Causes

Management

Do's

Dont's

References

  1. ↑ Nienaber, CA.; Eagle, KA. (2003). "Aortic dissection: new frontiers in diagnosis and management: Part I: from etiology to diagnostic strategies". Circulation. 108 (5): 628–35. doi:10.1161/01.CIR.0000087009.16755.E4. PMID 12900496. Unknown parameter |month= ignored (help)
  2. ↑ Tsai, TT.; Nienaber, CA.; Eagle, KA. (2005). "Acute aortic syndromes". Circulation. 112 (24): 3802–13. doi:10.1161/CIRCULATIONAHA.105.534198. PMID 16344407. Unknown parameter |month= ignored (help)
  3. ↑ DEBAKEY, ME.; HENLY, WS.; COOLEY, DA.; MORRIS, GC.; CRAWFORD, ES.; BEALL, AC. (1965). "SURGICAL MANAGEMENT OF DISSECTING ANEURYSMS OF THE AORTA". J Thorac Cardiovasc Surg. 49: 130–49. PMID 14261867. Unknown parameter |month= ignored (help)
  4. ↑ Daily, PO.; Trueblood, HW.; Stinson, EB.; Wuerflein, RD.; Shumway, NE. (1970). "Management of acute aortic dissections". Ann Thorac Surg. 10 (3): 237–47. PMID 5458238. Unknown parameter |month= ignored (help)

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