Approach to the Treatment of Aortic Dissection

Research output: Contribution to journalReview article

23 Scopus citations

Abstract

Acute aortic dissection is a fatal disease if early diagnosis and institution of appropriate therapy are delayed. Unfortunately, the presentation of a dissection can be diabolical, leading to an initial misdiagnosis in more than 25% of patients. For type A dissections, surgical repair is essential because mortality rates approach 50% at 48 hours with expectant therapy alone. For type B dissections, medical management is successful in most patients, although a subset with complications or early dilation may benefit from newer endovascular techniques. The goal of this review is to summarize the diagnostic algorithm, initial therapeutic options, and long-term management regimen that offer patients with an acute aortic dissection the best chance for short-term and long-term survival. There is an emphasis on the specific practical approach that is applied at Washington University to patients who present with an aortic dissection.

Original languageEnglish
Pages (from-to)869-893
Number of pages25
JournalSurgical Clinics of North America
Volume89
Issue number4
DOIs
StatePublished - Aug 1 2009

Keywords

  • Acute dissection
  • Chronic dissection
  • Diagnosis
  • Endovascular treatment
  • Medical treatment
  • Surgical treatment

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