Tchana-Sato V, Sakalihasan N, Defraigne J O
Service de Chirurgie Cardiovasculaire, CHU de Liège, Site Sart Tilman, Liège, Belgique.
Rev Med Liege. 2018 May;73(5-6):290-295.
Aortic dissection is a life-threatening condition due to a tear in the intimal layer of the aorta or bleeding within the aortic wall, resulting in the separation of the different layers of the aortic wall. Among the risk factors, age, hypertension, dyslipidemia and genetic disorders of the connective tissue have been identified. A prompt diagnosis and an adequate treatment are important in the management of affected patients. The type of treatment depends on the location and extension of the dissection. Open surgical repair is most commonly used for dissections involving the ascending aorta and the aortic arch, whereas endovascular intervention is indicated for descending aorta dissections that are complicated. In this paper, we will review the epidemiology, and physiopathology of aortic dissection and describe the appropriate management for each type of dissection (open surgery, endovascular or medical treatment).
主动脉夹层是一种危及生命的疾病,原因是主动脉内膜层撕裂或主动脉壁内出血,导致主动脉壁各层分离。在风险因素中,已确定年龄、高血压、血脂异常和结缔组织遗传疾病。对受影响患者的管理中,及时诊断和适当治疗很重要。治疗类型取决于夹层的位置和范围。开放手术修复最常用于累及升主动脉和主动脉弓的夹层,而血管内介入适用于复杂的降主动脉夹层。在本文中,我们将回顾主动脉夹层的流行病学和生理病理学,并描述每种类型夹层(开放手术、血管内或药物治疗)的适当管理。