Aortic dissection - Stanford A

Case contributed by Assoc Prof Frank Gaillard

Single image through the aortic arch demonstrates an aortic dissection. Involvement of the ascending aorta is consistent with a Stanford Type A aortic dissection.

 

Case Discussion

Thoracic aortic dissection is commonly divided according to the Stanford classification into type A (involving the ascending aorta or aortic arch) and type B (involving the descending thoracic aorta only). The main causes of dissection are hypertension, atherosclerosis, Marfan’s syndrome, Ehlers-Danlos syndrome, vasculitis, pregnancy and iatrogenic (aortic catheterization).

Complications of aortic dissection include dissection and occlusion of branch vessels, distal thromboembolism, aneurysmal dilatation and aortic rupture. Type A dissection may also result in coronary artery occlusion, aortic regurgitation and pericardial tamponade and therefore management of this type of dissection is usually emergency surgical repair. Type B dissections are usually managed with aggressive blood pressure control unless there are complications.

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