Aortic dissection Flashcards
1
Q
Is AAA or aortic dissection more common?
A
aortic dissection 3x more common
2
Q
What are the risk factors for aortic dissection
A
HTN, cocaine, bicuspid aortic valve, smoking, cardiac surgery, connective tissue disorders
3
Q
What happens in aortic dissection?
A
intima tears and blood fills layers between it and media
4
Q
How is dissection diagnosed?
A
CT angiogram
5
Q
How is Stanford classification divided?
A
Type A: dissection involves the ascending aorta with or without involvement of the arch and descending aorta. Accounts for 60-70% of cases. Type B (TBAD): Involves only the descending aorta (distal to the left subclavian artery) and/or abdominal aorta. Accounts for 30-40% of cases
6
Q
Describe three complications of aortic dissection
A
aortic rupture
MI
cardiac tamponade acute aortic regurg Renal failure Bowel ischaemia Acute limb ischaemia
7
Q
List two signs of dissection on CT
A
- Double lumen (true and false lumens) thus confirming the diagnosis of AAD
- The entry tear (where the dissection begins)
- Any evidence of aortic dilatation (aneurysmal change)
- Evidence of end-organ malperfusion (for example non-enhancing kidney)
- Features of acute rupture (including extravasation of contrast or haemothorax)
8
Q
What are the indications for surgery in aortic dissection?
A
Type A or retrograde type B
Persistent pain
Aortic rupture
Extension despite optimal medical management