Robicsek F, Thubrikar M J
Carolinas Heart Institute, Carolinas Medical Center, Charlotte, North Carolina.
Ann Thorac Surg. 1994 Oct;58(4):1247-53. doi: 10.1016/0003-4975(94)90523-1.
We describe the hemodynamic principles that we postulate are responsible for the development of aortic dissection. Two types are differentiated: the "hypertensive" and the "Marfan" types. The former is characterized by moderate aortic dilatation and considerable blood pressure elevation, the latter by considerable aortic dilatation only. The role of wall stress in the development of the intimal tear and the propagation of the process of dissection are discussed. We recommend that patients who are at high risk for developing aortic dissection--those with Marfan's syndrome and dilated aortas--should undergo aortoplasty and wall reinforcement as a simple, safe, and effective way to prevent aortic dissection.
我们阐述了我们假定的导致主动脉夹层形成的血流动力学原理。区分出两种类型：“高血压型”和“马方综合征型”。前者的特征是主动脉中度扩张和血压显著升高，后者仅表现为主动脉显著扩张。讨论了壁应力在内膜撕裂形成及夹层过程扩展中的作用。我们建议，有发生主动脉夹层高风险的患者——患有马方综合征且主动脉扩张的患者——应接受主动脉成形术和强化血管壁，作为预防主动脉夹层的一种简单、安全且有效的方法。
