Learn All About Aortic Dissection

According to studies, 75% of patients with aortic dissection die before reaching the hospital. Without treatment, the mortality rate is 90% in the first three months. 
Learn all about aortic dissection

Aortic dissection is a very serious type of trauma. Unfortunately, this type of traumatic aortic fracture manifests itself. Taken together, these injuries are directly responsible for between 16 and 40% of deaths, surpassed only by head trauma.

Traffic accidents are among the most common causes of this condition as well as falling objects.

According to studies, 75% of patients with aortic dissection die before reaching the hospital. Without treatment, the mortality rate approaches 90% in the first three months. The chances of survival are determined by the severity of the dissection, associated injuries and the treatment used.

Classification of aortic dissection

Aortic dissection: The heart

In general, physicians determine the appropriate treatment based on a classification of several types:

  • Class I. These dissections are treated with beta-blockers and monitored until they stabilize or disappear.
  • Class II. These require immediate surgery. In addition, they also include those who are being held in place by pseudoaneurysms. Nevertheless, they still present secondary signs of severe dissection.
  • Finally, there is intramural hemotoma or penetrating ulcer. In these cases, the treatment depends on other factors. These include dissection stability, the absence of secondary signs of severity, and other associated injuries.

Symptoms of aortic dissection

The patient’s symptoms will also influence the choice of treatment. Here we will highlight the associated signs of severe aortic dissection and dissection stability.

These include:

  • Pseudo-coarctation. An abnormality in the aorta.
  • Severe bruising.
  • Massive left hemothorax.
  • The size of the pseudoaneurysm or involvement of more than 50% of the circumference.

Unfortunately, these factors increase the degree of aortic dissection. Therefore, they need urgent surgery, while their absence allows for optional treatment. Another factor of similar importance is hypotension before the hospital visit.

Diagnosis

Veins

In recent years , there has been a revolution in both diagnosis and treatment options. It has thus evolved along with multidetector technology and the introduction of new endovascular surgery techniques.

This has made it possible for small dissections not to go unnoticed. It has also led to a decrease in mortality that is directly related to choice of procedure and treatment time.

The natural development of aortic dissection depends on several variables. Although the type of dissection is a crucial factor, it is not the only one. These variables determine the need or appropriate time and treatment.

In short, there has been a revolution in the diagnosis of aortic dissection due to improvements in X-rays. Now doctors can identify a minimal aortic dissection that would previously have been hidden and is not always accompanied by bleeding.

Treatment

There are three ways doctors treat this condition:

  • Medical treatment with beta-blockers, calcium channel blockers and vasodilators to lower blood pressure, often associated with anticoagulation.
  • Endovascular surgery.
  • Open surgical operation.

Physicians can perform the procedure immediately or on a semi-optional or scheduled basis. In terms of endovascular repair that has evolved in recent years, it leads to less surgery time, less need for transfusions and shorter hospital stays compared to patients undergoing open surgery.

These data suggest that this is a good idea as the chosen treatment for patients with favorable anatomy and even in children with thoracic aortic dissection.

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