Dissecting Aneurysm of the Descending Aorta

Diagnosis and management of aortic dissection Task Force on Aortic Dissection, European Society of Cardiology

“…The first attempt to further subdivide the De Bakey classification was made by Reul and Cooley (Fig. 4), differentiating from thoracic abdominal type III dissection [88] . Subdividing into proximal and distal or ascending and descending aortic dissections is also common.…”

“…Figure 4 Schematic drawing of aortic dissection class 1, subdivided into DeBakey types I, II and III. Also depicted are Stanford classes A and B with subtypes a and b (subtype depends on the thoracic or abdominal involvement according to Reul and Cooley [88] ).…”

“…Multiorgan failure is a major cause of death after medical or surgical therapy [6,[86][87][88]114] . Flow in abdominal arteries is very often impaired.…”

“…The majority of late deaths following primary surgery of acute aortic dissection has been due to rupture of the aorta [88] . Therefore, timely reoperation (Table 19) is required whenever necessary.…”

Atraumatic ischaemic myelopathy

“…It is estimated that the incidence of ischaemic myelopathy following surgery on thoracic aorta for coarctation, aneurysms and dissecting aneurysm is 0'5 per cent (Blaisdell & Cooley, 1962, Brewer et al, 1972, Pasternak et al, 1972, Crawford & Rubio, 1973, Reul et al, 1975 (1973) had only four patients with paraplegia out of 83 patients operated on for thoracic aortic aneurysms distal to the common carotid artery. Three of these four patients were in hypovolemic shock, and the fourth patient developed spinal cord damage 4 days after the resection of aneurysm following a period of hypotension.…”