Stanford Type A Aortic Dissection: a Complex Disease for Patients and Cardiothoracic Surgeons

Abstract

An intimal tear propagating within the media either proximally or distally is the primary etiology of aortic dissection. The tear can occurs anywhere in the aorta but more frequently in the ascending portion. The blood will flow predominantly in a new lumen called "false lumen" separated from the true lumen by a thin intimal flap and contained by the aortic adventitia. The false lumen may propagates propagate proximally all the way to the aortic valve and CRIMSONpublishers http://www.crimsonpublishers.com AbstractAcute type A aortic dissection is a catastrophic event in which blood exits the vascular lumen and dissects the media, creating a false lumen. Surgery is the best possible treatment but it is complex. The surgical team needs to understand the anatomy and physiopathology before dealing with the repair. While there are just a few surgical solutions for the repair of the dissected ascending aorta, debate is still ongoing about the best surgical option for the disease involving the arch and the descending aorta. Late reoperations are relatively common on the aortic valve and/or the distal aorta after primary repair. Results are excellent in specialized centers with high volume and complexity. Lifelong follow-up is required in survivors.