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Acute aortic dissection

Thierry Carrel1, Thoralf M Sundt2, Yskert von Kodolitsch3

  • 1Department of Cardiac Surgery, University Hospital Zurich, Zurich, Switzerland.

Lancet (London, England)
|January 14, 2023
PubMed

Insights

Acute aortic dissection is a complex cardiovascular event with high mortality. Understanding its pathophysiology and evolving classifications is key to improving prevention, diagnosis, and treatment strategies for better patient outcomes.

Area of Science:

  • Cardiovascular Medicine
  • Vascular Surgery
  • Medical Pathophysiology

Background:

  • Acute aortic dissection (AAD) presents significant mortality and morbidity challenges.
  • Recent advancements enhance understanding of AAD pathophysiology.
  • Existing classifications are evolving towards a unified nomenclature based on morphology and function.

Purpose of the Study:

  • To provide a clinically relevant overview of AAD prevention, diagnosis, and management.
  • To discuss the evolving understanding of AAD pathophysiology and classification.
  • To summarize current evidence for AAD treatment and follow-up.

Main Methods:

  • Review of recent scientific literature and clinical evidence on acute aortic dissection.
  • Analysis of pathophysiological pathways, including intimal tear location and aortic wall disruption.
  • Evaluation of current diagnostic and management strategies.

Main Results:

  • Pathophysiology insights guide treatment decisions (surgery, endovascular, medical).
  • Morphology and function-based classification is emerging.
  • Evidence for optimal management and follow-up continues to develop.

Conclusions:

  • Effective prevention, diagnosis, and treatment of AAD are critical.
  • Understanding intimal tear and aortic segment involvement is crucial for management.
  • This review offers a comprehensive overview for clinicians managing AAD.

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