Treat acute Descending aortic dissection

Question 1

Patients with type B acute aortic dissection without evidence of cardiogenic shock should be initially treated with?

Answer 1

Medical therapy to control heart rate and reduce blood pressure.

Question 2

first-line treatment

Answer 2

Intravenous β-blockers

Question 3

Can be added if hypertension does not completely respond to β-blocker therapy?

Answer 3

sodium nitroprusside

Question 4

Current guidelines recommend reducing systolic blood pressure to _____ or less in the first hour in patients with aortic dissection.

Answer 4

120 mm Hg

Question 5

In patients with type B acute aortic dissection without evidence of cardiogenic shock, pain control is best accomplished with?

Answer 5

intravenous opioids

Question 6

Management in patients with ascending aortic dissection (type A aortic dissection), intramural aortic hematoma, or descending aortic dissection (type B aortic dissection) with complications?

Answer 6

immediate repair is warranted.

Question 7

Complications are defined as?

Answer 7

refractory pain, rapid aneurysmal expansion, rupture, or malperfusion syndrome.

Question 8

After medical stabilization, thoracic endovascular aortic repair (TEVAR) with stent grafting can be used; typical indications include?

Answer 8

descending aortic aneurysm diameter greater than 6.0 cm, rapid growth (>0.5 cm/year), or end-organ damage.

Question 9

TEVAR has the advantage over surgical operation with?

Answer 9

lower morbidity and shorter hospital stay

Question 10

thoracic endovascular aortic repair (TEVAR) with stent grafting complications include?

Answer 10

stroke, spinal ischemia, and aortic graft endoleaks.

Question 11

Open surgical repair of the descending aorta is not recommended in patients with uncomplicated type B aortic dissection because of?

Answer 11

high rates of morbidity (such as paraplegia) and mortality.

Question 12

Repeat CT angiography at 12 hours is not indicated unless?

Answer 12

patient does not stabilize with medical therapy.

Question 13

Serial imaging (usually magnetic resonance angiography) is typically performed in?

Answer 13

asymptomatic patients at the time of discharge

Question 14

Serial imaging (usually magnetic resonance angiography) is periodically done in patients after discharge who do not have an indication for aneurysmal repair to screen for?

Answer 14

extension or recurrence of the dissection, aneurysm formation, and leakage.