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Related Experiment Videos

Aortic dissection and aortic aneurysm surgery

L G Svensson1, S B Labib

  • 1Department of Cardiovascular and Thoracic Surgery, Lahey Clinic, Burlington, MA 01805.

Current Opinion in Cardiology
|March 1, 1994
PubMed
Summary
This summary is machine-generated.

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Noninvasive imaging like MRI and TEE accurately detect aortic dissection. Medical therapy is preferred for descending aortic dissection, while surgical repair is recommended for ascending aorta and arch dissection.

Area of Science:

  • Cardiology
  • Radiology
  • Vascular Surgery

Background:

  • Noninvasive imaging modalities for aortic dissection, including MRI, CT, and TEE, have evolved.
  • Accurate diagnosis is crucial for timely and appropriate management of aortic dissection.

Purpose of the Study:

  • To review the current role of noninvasive imaging in diagnosing aortic dissection.
  • To discuss contemporary management strategies for various types of aortic dissection.
  • To evaluate the safety and efficacy of surgical and percutaneous interventions.

Main Methods:

  • Review of current literature on noninvasive imaging techniques (MRI, CT, TEE) for aortic dissection.
  • Analysis of treatment guidelines and outcomes for ascending, arch, descending thoracic, and thoracoabdominal aortic dissections.

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  • Evaluation of emerging percutaneous techniques and their safety profiles.

    • Main Results:

    • MRI and TEE demonstrate high accuracy in detecting aortic dissection, though TEE may have artifacts mimicking intimal flaps.
    • Immediate surgical repair is generally recommended for ascending aorta and aortic arch dissection, with ongoing debate on arch replacement.
    • Medical management with beta-blockers and antihypertensives is preferred for descending thoracic and thoracoabdominal aortic dissections unless complications arise.
    • Percutaneous techniques like fenestration, stenting, and intraluminal grafting are increasingly utilized.

    Conclusions:

    • Noninvasive imaging plays a vital role in diagnosing aortic dissection, with careful interpretation needed to avoid false positives.
    • Management strategies vary based on the location and extent of the dissection, with a trend towards less invasive approaches.
    • Deep hypothermia with circulatory arrest is the preferred technique for complex aortic arch repairs.
    • Further research is needed to optimize percutaneous techniques and long-term outcomes for all types of aortic dissection.