[Pathophysiology and complications of aortic dissection]

The dissection is termed Type A according to the Stanford classification, if the ascending aorta is involved. It is termed type B, if the ascending aorta is not involved. Most patients with Type A aortic dissection die from intrapericardial rupture with cardiac tamponade, free pleural rupture, massive aortic regurgitation, or coronary or cerebral malperfusion (ischemic heart disease or stroke). Most patients with Type B dissection die from free pleural rupture or renal or visceral vascular complications. The resultant compromise of various aortic branches (inomunate, carotid, subclavian, spinal, renal, superior mesentric, or iliac arteries) results in a wide variety of symptoms and signs (shock, dyspnea, stroke, paraplegia, anuria, abdominal pain or extremity ischemia).