Department of Medicine, Division of Cardiology, Zena and Michael A. Wiener Cardiovascular Institute and Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, Icahn School of Medicine at Mount Sinai, New York, New York.
Department of Surgery, Division of Vascular Surgery, Icahn School of Medicine at Mount Sinai, New York, New York.
J Am Coll Cardiol. 2014 Oct 21;64(16):1725-39. doi: 10.1016/j.jacc.2014.08.025.
Aortic dissection is the most devastating complication of thoracic aortic disease. In the more than 250 years since thoracic aortic dissection was first described, much has been learned about diseases of the thoracic aorta. In this review, we describe normal thoracic aortic size; risk factors for dissection, including genetic and inflammatory conditions; the underpinnings of genetic diseases associated with aneurysm and dissection, including Marfan syndrome and the role of transforming growth factor beta signaling; data on the role for medical therapies in aneurysmal disease, including beta-blockers, angiotensin receptor blockers, and angiotensin-converting enzyme inhibitors; prophylactic surgery for aneurysm; surgical techniques for the aortic root; and surgical and endovascular management of aneurysm and dissection for different aortic segments.
主动脉夹层是胸主动脉疾病最具破坏性的并发症。自首次描述胸主动脉夹层以来的 250 多年里，人们对胸主动脉疾病有了更多的了解。在这篇综述中，我们描述了正常的胸主动脉大小；夹层的危险因素，包括遗传和炎症状况；与动脉瘤和夹层相关的遗传疾病的基础，包括马凡综合征和转化生长因子β信号的作用；关于动脉瘤病的药物治疗作用的数据，包括β受体阻滞剂、血管紧张素受体阻滞剂和血管紧张素转换酶抑制剂；动脉瘤的预防性手术；主动脉根部的手术技术；以及不同主动脉节段的动脉瘤和夹层的手术和血管内治疗。
