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主动脉夹层的当前认识

Current Understanding of Aortic Dissection.

作者信息

Yuan Xun, Mitsis Andreas, Nienaber Christoph A

机构信息

Cardiology and Aortic Centre, Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London SW3 6NP, UK.

National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London SW7 2BX, UK.

出版信息

Life (Basel). 2022 Oct 14;12(10):1606. doi: 10.3390/life12101606.

Abstract

The aorta is the largest artery in the body, delivering oxygenated blood from the left ventricle to all organs. Dissection of the aorta is a lethal condition caused by a tear in the intimal layer of the aorta, followed by blood loss within the aortic wall and separation of the layers to full dissection. The aorta can be affected by a wide range of causes including acute conditions such as trauma and mechanical damage; and genetic conditions such as arterial hypertension, dyslipidaemia, and connective tissue disorders; all increasing the risk of dissection. Both rapid diagnostic recognition and advanced multidisciplinary treatment are critical in managing aortic dissection patients. The treatment depends on the severity and location of the dissection. Open surgical repair is the gold standard of treatment for dissections located to the proximal part of the aorta and the arch, while endovascular interventions are recommended for most distal or type B aortic dissections. In this review article, we examine the epidemiology, pathophysiology, contemporary diagnoses, and management of aortic dissection.

摘要

主动脉是人体最大的动脉,将左心室的含氧血液输送到所有器官。主动脉夹层是一种致命疾病,由主动脉内膜层撕裂引起,随后主动脉壁内出血,各层分离直至完全夹层形成。主动脉可受多种原因影响,包括创伤和机械损伤等急性情况;以及动脉高血压、血脂异常和结缔组织疾病等遗传情况;所有这些都会增加夹层形成的风险。快速的诊断识别和先进的多学科治疗对于主动脉夹层患者的管理至关重要。治疗取决于夹层的严重程度和位置。开放手术修复是主动脉近端和弓部夹层治疗的金标准,而对于大多数远端或B型主动脉夹层,建议采用血管内介入治疗。在这篇综述文章中,我们研究了主动脉夹层的流行病学、病理生理学、当代诊断方法和治疗。

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