[Pathoanatomic criteria for dissecting aortic aneurysm]

The authors present the basic pathoanatomic criteria for the diagnosis of dissecting aortic aneurysm on the basis of an analysis of 144 cases of this abnormality. Its mandatory signs are the inlet (of blind rupture of the wall of the aorta) and channel of its dissection. The inner surface of the dissection channel varies with the time of (rough to smooth) dissection with connective tissue bands. The optional criteria are the outlet that connects the false aortic lumen with the true one, as well as the propagation of dissection to the visceral aortic branches. When the visceral branches are involved in the process of dissection in more than half of all cases, there are no changes in the respective organs. At the same time there are ischemic changes in the organs, the vessels of which are not involved in this process. This is suggestive of complex circulatory disorders in this disease. The main mechanisms of tanatogenesis are due to the rupture of the outer sheet of a false passage, the propagation of dissection to the visceral branches or a combination of these two factors. The optimal autopsy procedure options are shown with regard to the pathoanatomic features of dissecting aortic aneurysm.