Abstract
Aortic dissection is the most common catastrophe involving the aorta. It occurs in approximately one in every 30–500 patients and is more frequent than rupture of an abdominal aortic aneurysm. Two important contributing factors in the development of aortic dissection are hypertension and disease of the aortic media; an abnormality of the aortic media is present in almost all cases. Lesions of the aorta which predispose to dissection have been classified as elastic tissue defects, muscular lesions or combined lesions of the media. Marfan’s syndrome is a classic example of an elastic tissue defect. Approximately 71% of patients with cardiovascular manifestations of this syndrome have aortic dissection. Elastic lesions are the most common finding in patients presenting with aortic dissection under the age of 40 years, while muscular lesions predominate in patients over 40. Medial degeneration is occasionally caused by a combination of elastic and muscular lesions. Conditions such as rheumatoid arthritis, scleroderma, giant cell arteritis, granulomatous arteritis and ankylosing spondylitis are associated with combined medial degeneration. Degeneration of the aorta with ageing and atherosclerosis predisposes to dissection. Hypertension has been identified in approximately 70% of patients with aortic dissection. Dissection occurs with increased frequency in conditions in which hypertension is common, such as pregnancy, congenital bicuspid aortic valve and coarctation of the aorta. Iatrogenic causes secondary to aortic cannulation, catheterization procedures or intra-aortic balloon placement are seen with increasing frequency as the number of invasive procedures performed on the cardiovascular system rises.
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© 1994 Springer Science+Business Media Dordrecht
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McFadden, P.M., Ochsner, J.L. (1994). Surgical technique for aortic dissection. In: Jamieson, C.W., Yao, J.S.T. (eds) Vascular Surgery. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-6854-8_14
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DOI: https://doi.org/10.1007/978-1-4899-6854-8_14
Publisher Name: Springer, Boston, MA
Print ISBN: 978-0-412-58630-9
Online ISBN: 978-1-4899-6854-8
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