TP2.3 - Tratamento da Patologia da Aorta Torácica

Question 1

Aneurismas Aórticos Torácicos?

Answer 1

Usually asymptomatic and diagnosed by imaging
Variable localization dilation
Variable growth rate with pathology and localization
Risk of rupture or dissection
Operative indication according to type of aortopathy, location and associated risk factors

Question 2

Aortic Disease associated with Bicuspid Aortic Valve (BAV)?

Answer 2

BAV is the most frequent congenital heart abnormality
Risk of aortic dilation in patients with BAV is much higher than that of the population with normal aortic valve
BAV is a risk factor for dissection and rupture of the aorta

Question 3

Síndromes Aórticos Agudos?

Answer 3

Classic Aortic Dissection (Class I)
Intramural Hematoma (Class II)
Localized Dissection (Class III)
Penetrating Atherosclerotic Ulcer (Class IV)
Provoked Dissection (Class V)

Question 4

Acute Aortic Dissection Presentation?

Answer 4

Often acute presentation
Patients often in critical condition
Global mortality in the acute setting is 15-50%
-Rupture
-Tamponade
-Acute aortic regurgitation
-Malperfusion

Question 5

Classificação de Stanford?

Answer 5

Type A - Involve aorta ascendente

Type B - Não involve aorta ascendente

Question 6

Classificação DeBakey?

Answer 6

Type I - Toda a aorta
Type II - apenas aorta ascendente
Type III - posterior a aorta ascendente
Type IV - posterior a aorta ascendente e ultrapassa art renais

Question 7

TAAD vs TBAD?

Answer 7

TAAD requires emergent surgery but preoperative and intraoperative strategies depend heavily on other aspects of the disease/patient - Open Surgery
TBAD requires conservative treatment but some patients fare much worse than ohters - Endovascular Surgery

Question 8

TEM System?

Answer 8

Type
Entry
Malperfusion

Question 9

Acute Aortic Syndromes If symptomatic?

Answer 9

Place large-bore IV, Bladder Cath, and arterial line.

Aggressive HR, BP, and pain control.

Question 10

AAS Treatment goals?

Answer 10

Primary
-Stop bleeding
-Restore flow
-Minimize complications
Secondary
-Positive aortic remodeling
-Facilitate future interventions