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AORTIC DISSECTION

 Aortic dissection occurs when blood splays apart the laminar planes of the media to form a blood-filled channel within the aortic wall.

AGE GROUPS;

Aortic dissection occurs mainly in two age groups:

(1) men aged 40 to 60 with antecedent hypertension (more than 90% of cases)

 (2) younger patients with connective tissue abnormalities that affect the aorta (e.g., Marfan syndrome). Dissections also can be iatrogenic (e.g., complicating arterial cannulation during diagnostic catheterization or cardiopulmonary bypass).

(3) for unknown reasons, pregnant women develop dissection of the aorta or its branches, including the coronary arteries.

CLINICAL CONSEQUENCES

The clinical manifestations of dissection depend primarily on the portion of the aorta affected, aorta and arch

CLASSIFICATION

Aortic dissections generally are classified into two types

Proximal lesions: type A dissection, involving the ascending aorta, with or without involvement of the descending aorta (DeBakey type I or II, respectively)

Distal lesions, usually beginning beyond the subclavian artery: type B dissections (DeBakey type III)


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