TSRA Book - Review of Cardiothoracic Surgery - 75-81 Aorta

Question 1

Describe the aortic root anatomy.

Answer 1

The AV junction is also known as the annulus (not true fibrous annulus)

Question 2

Describe the annular attachments of the aortic root to the ventricle.

Answer 2

45% of the root is attached to the ventricle, the other 55% is attached to the fibrous skeleton of the heart, specifically the membranous septum and the aortomitral curtain

Question 3

What are the three acute aortic syndromes?

Answer 3

aortic dissection, intramural hematoma, penetrating aortic ulcer

Question 4

Describe the pathophysiology of an aortic dissection. What layers does it affect?

Answer 4

Tear in the INTIMA, separation of the layers of the MEDIA, creating a true and false lumen. Pulsatile flow can cause propagation (ante or retro)

Question 5

What are the non-communicating acute aortic syndromes?

Answer 5

IMH and PAU

Question 6

Describe the pathophysiology of IMH?

Answer 6

either spontaneous rupture of vaso vasorum or thrombosed false lumen