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In uncomplicated aortic dissections, no benefit has been demonstrated over medical management alone. In uncomplicated type B aortic dissection, TEVAR does not seem either to improve or compromise 2-year survival and adverse event rates. [7] Its use in complicated aortic dissection is under investigation.
The target blood pressure should be a mean arterial pressure (MAP) of 60 to 75 mmHg, or the lowest blood pressure tolerated. Initial decreases should be by about 20%. [2] The target heart rate is less than 65 beats per minute. Long-term blood pressure control is required for every person who has experienced aortic dissection. [42] [43]
New or worse post-procedure symptoms that require attention include dizziness or light-headedness, swelling of the ankles, sudden weight gain, extreme fatigue with activity, and signs of infection. Emergency attention is required for chest pain, pressure or tightness, severe, sudden shortness of breath, or fainting.
The most common risk factor for type B aortic dissection is hypertension. The first line treatment for type B aortic dissection is aimed at reducing both heart rate and blood pressure and is referred to as anti-impulse therapy. A thoracic aortic stent graft, seen on chest X-ray which was placed during a TEVAR procedure.
Less common presentations include intracranial bleeding, aortic dissection, and pre-eclampsia or eclampsia. [6] Massive, rapid elevations in blood pressure can trigger any of these symptoms, and warrant further work-up by physicians. Physical exam would include measurement of blood pressure in both arms.
The Bentall procedure is a type of cardiac surgery involving composite graft replacement of the aortic valve, aortic root, and ascending aorta, with re-implantation of the coronary arteries into the graft. This operation is used to treat combined disease of the aortic valve and ascending aorta, including lesions associated with Marfan syndrome.
In addition, blood flow bypasses the native valve and exits the heart through the implanted valved conduit. The procedure is effective at relieving excessive pressure gradient across the natural valve. High pressure gradient across the aortic valve can be congenital or acquired. A reduction in pressure gradient results in relief of symptoms.
Acute aortic syndrome (AAS) describes a range of severe, painful, potentially life-threatening abnormalities of the aorta. [1] These include aortic dissection, intramural thrombus, and penetrating atherosclerotic aortic ulcer. [2] AAS can be caused by a lesion on the wall of the aorta that involves the tunica media, often in the descending ...
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