Zusammenfassung
Dissektionen, die den Aortenbogen betreffen und bei denen die Aorta ascendens nicht am Dissektionsprozess beteiligt ist, bleiben in den aktuellen Klassifikationen unberücksichtigt, obwohl jeder 10. Dissektionspatient eine sog. Non-A-non-B-Aortendissektion aufweist. Ein Drittel dieser Patienten muss aufgrund einer Aortenruptur oder einer Organmalperfusion notfallmäßig operiert werden. Fast alle Patienten mit einer Non-A-non-B-Dissektion benötigen früher oder später eine Aortenoperation. Die Non-A-non-B-Aortendissektion kann mithilfe unterschiedlicher Methoden behandelt werden. Dabei ist wichtig, das Entry im Aortenbogen zu verschließen und eine endovaskuläre Behandlung bei Patienten mit Entry im Aortenbogen zu vermeiden.
Abstract
The current aortic dissection classifications do not consider the situation when the dissection process involves the aortic arch but not the ascending aorta, so-called non-A non-B aortic dissection. Every tenth patient with an acute aortic dissection has a non-A non-B dissection and one third of these undergo emergency aortic surgery for aortic rupture or organ malperfusion. Almost all patients with non-A non-B aortic dissection require aortic surgery sooner or later. There are several surgical and interventional treatment options. It is crucial to close the entry into the aortic arch and to avoid endovascular treatment of patients in cases of an entry located in the aortic arch due to the risk of retrograde type A dissection.
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B. Rylski, M. Siepe, M. Pérez, S. Kondov, M. Kreibich, F. Beyersdorf und M. Czerny geben an, dass kein Interessenkonflikt besteht.
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Rylski, B., Siepe, M., Pérez, M. et al. Akute Non-A-non-B-Aortendissektion. Z Herz- Thorax- Gefäßchir 32, 339–342 (2018). https://doi.org/10.1007/s00398-018-0230-1
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DOI: https://doi.org/10.1007/s00398-018-0230-1