A dissection was identified in either the ascending aorta with or without extension into the arch in 37 (30.6%) of 121 patients or in the descending aorta in 75 (62.0%) patients. Dissection aortique de type B avec nécrose œsophagienne aiguë Author links open overlay panel Esther van de Wal-Visscher 1 Grard A.P. © 2020 Springer Nature Switzerland AG. Some cases of aortic dissection may result in rupture, causing collapse and often death. Aortic root replacement in 372 Marfan patients: evolution of operative repair over 30 years. Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. 360: k678. CardioVascular and Interventional Radiology, Molecular Genetics & Genomic Medicine, Vol. Many radiologists classify any dissection involving or extending proximal to the left subclavian artery as a type A dissection whether or not it involves an arch vessel. Rogers AM, Hermann LK et al. Surgical or endovascular intervention is reserved for patients with recurrent pain, aortic expansion, dissection progression, or end-organ malperfusion (18). Dissection of the descending thoracic aorta extending into the ascending aorta.

In this system, dissections are organized into three types: Type 1 arises in the ascending aorta and extends distal to the ascending aorta for a variable distance. 2, 27 August 2016 | Emergency Radiology, Vol. In our case, we opted for a different management. 4 Recommendations for accurate CT diagnosis of suspected acute aortic syndrome (AAS)—on behalf of the British Society of Cardiovascular Imaging (BSCI)/British Society of Cardiovascular CT (BSCCT) In our case, the impending decrease in mean arterial pressure below 45 mmHg was treated with a continuous infusion of norepinephrine using a syringe pump. Radiology. Mosby Inc. (2007) ISBN:0323040683. Nazerian P, Mueller C et al. The proposed simplified system is divided into (a) proximal aortic dissection involving the aorta proximal to the origin of the left subclavian artery and (b) distal aortic dissection limited to the aortic segments distal to the origin of the left subclavian artery and not involving the aorta proximal to that site (6). Causes include: Imaging is essential in delineating the morphology and extent of the dissection as well as allowing for classification (which dictates management). PubMed Google Scholar. Although these arch dissections are uncommon, they occur with sufficient frequency to warrant further consideration with respect to classification and treatment (12–15). This case shows that intentional acceptance of respiratory depression in the newborn, which is induced by high-dose opioid administration, can be a successful option for anesthetic management in an emergency situation such as Cesarean delivery in a patient suffering from an acute aortic dissection. CTA has now replaced it as the first-line investigation, not only due to it being non-invasive but also on account of better delineation of the poorly opacifying false lumen, intramural hematoma and end-organ ischemia.

Image Predictors of Treatment Outcome after Thoracic Aortic Dissection Repair. Risks of angiography include general risks of angiography plus the risk of catheterizing the false lumen and causing aortic rupture.

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