Roudaut R, Laurent F, Dallocchio M
Service de Cardiologie, Hôpital du Haut Lévêque, Pessac.
Ann Cardiol Angeiol (Paris). 1992 Dec;41(10):525-9.
Previously with a drastic prognosis, aortic dissection has extensively benefitted from advances in medical and surgical treatment, as well as progress in methods of investigation. While aortography is classically the reference special investigation, non-invasive methods now have a place of choice both during the acute phase (transthoracic and transesophageal echocardiography) and the chronic phase or for the purpose of post-operative monitoring (CT scan, magnetic resonance imaging). In an emergency context, the most important point is to diagnose a type A dissection, involving the ascending aorta, the treatment of which is surgical. In the majority of cases the diagnosis can now be made on the basis of transthoracic and transesophageal echocardiographic findings, which also enable identification of the site of the portal of entry, extension and concomitant lesions, all important features to be taken into consideration regarding surgical tactics.
既往主动脉夹层的预后极差，但医学和外科治疗的进展以及检查方法的进步使其受益匪浅。虽然传统上主动脉造影是参考性的特殊检查，但现在非侵入性方法在急性期（经胸和经食管超声心动图）和慢性期或术后监测中都占据了首选地位（计算机断层扫描、磁共振成像）。在紧急情况下，最重要的是诊断累及升主动脉的A型夹层，其治疗方法是手术。现在，大多数情况下可以根据经胸和经食管超声心动图检查结果做出诊断，这些检查结果还能确定破口部位、病变范围及合并病变，而这些都是手术策略中需要考虑的重要特征。
