Thoracic aortic dissection: Stanford type A

Case contributed by Dr Ian Bickle

Presentation

Sustained chest pain radiating into back. No evidence of MI on ECG or cardiac enzymes.

Patient Data

Age: 50 years
Gender: Male

Dissection emanating from the aortic root, extending into the right common carotid artery.

The flap extends through the thorax into the abdomen, with the origins of visceral vessels arising from both the false and true lumens.

Case Discussion

Thoracic aortic dissection is part of the spectrum of acute aortic syndrome.

Dissections are classified using the Stanford classification into Type A and B depending on the origin in relation to the left subclavian artery, which arises from the arch of aorta.

Broadly speaking:

Type A is treated with surgery.

Type B is treated with endolumincal stenting or medical treatment.

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