En la clasificación de Dubost, la disección abdominal representa del 1 al 2% de todas las disecciones aórticas, cuadro clínico aún más infrecuente si excluimos. El presente documento pretende ser una guía para la orientación diagnóstica y el tratamiento médico inicial de la disección aórtica aguda, proximal o distal. RESUMEN. Introducción: La disección aórtica es una enfermedad de pronóstico muy reservado, con una elevada mortalidad, aun cuando se diagnostique.
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Indications for the surgical treatment of aortic dissection include an acute proximal aortic dissection and an acute distal aortic dissection with one or more dseccion.
Other tests that may be used include an aortogram or magnetic resonance angiogram of the aorta.
Contrast is injected and the scan performed using a bolus tracking method. Show more Show less. Rupture leads to hemorrhaging into a body cavity, and prognosis depends on the area of rupture. Pseudohypotension falsely low blood-pressure measurement may occur due to involvement of the brachiocephalic diweccion supplying the right arm or the left subclavian artery supplying the left arm.
Strokemesenteric ischemiamyocardial ischemiaaortic rupture . For Stanford type A ascending aortic dissection, disccion management is superior to medical management. Previously thought to be the diagnostic gold standardit has been supplanted by other, less-invasive imaging modalities. The particular treatment used depends on the segment or segments of aorta involved. Anterograde dissections may propagate all the way to the iliac bifurcation of the aorta, rupture the aortic wall, or recanalize into the intravascular lumen leading to a double-barrel aorta.
It is djseccion relatively noninvasive test, requiring the individual to swallow the echocardiography probe. Surgery for aortic dissection was first introduced and developed by Michael E.
The Stanford system is used more commonly now, as it is more attuned to the management of the patient. Among the recognized risk factors for aortic dissection, hypertension, abnormally high levels of lipids such as cholesterol in the blood artica, and smoking tobacco aortida considered preventable risk factors.
Retrieved from ” https: Aortic dissection affects an estimated 2. A number of comorbid conditions increase the surgical risk of repair of an aortic dissection. Because aortic dissection may present to the emergency room physician similar to a myocardial infarction, the physician must be careful to make the proper diagnosis prior to initiating treatment for myocardial infarction since the treatment regimen for myocardial infarction can be lethal to an individual presenting with aortic dissection.
The American Journal of Cardiology. It is a noninvasive test, does not require the use of iodinated contrast material, and can detect and quantitate the degree of aortic insufficiency. Acute infrarenal abdominal aortic dissection. The risk of death is highest in the first two years after the acute event, and individuals should be followed closely during this time period. The proximity of the aorta to the esophagus allows the use of higher-frequency ultrasound for better anatomical images.
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Iatrogenic causes include trauma during cardiac catheterization or due to an intra-aortic balloon pump. People with an aortic dissection often have a history of high blood pressure ; the blood pressure is quite variable at presentation with acute aortic dissection, and tends to be higher in individuals with dieccion distal dissection.
The procedure is known as aortography. Proximal aortic dissections tend to be more associated with weakening of the vascular wall due to cystic medial degeneration. It has become the preferred imaging modality for suspected aortic dissection.
The cause of the infarction is involvement of the coronary arterieswhich supply the heart with oxygenated blood, in the dissection. If there is high clinical suspicion, a more sensitive imaging test CT angiogramMR angiographyor transesophageal echo may be warranted. Ultrasound of the Week. Long-term blood pressure control is required for every person who has experienced arotica dissection. Due to the high pressures in the aorta, blood enters the media at the point of the tear.
Separating the false lumen from the true lumen is a layer of intimal tissue known as the intimal flap. Continuing navigation will aortixa considered as acceptance of this use. Because of the varying symptoms of aortic dissection, the diagnosis is sometimes difficult to make.
Aortic dissection may be a late sequela of heart surgery. Also, the area of dissection is removed and replaced with a Dacron graft to prevent further dissection from occurring.
Disección aórtica aguda abdominal infrarrenal | Angiología
DeBakeyis an anatomical description of the aortic dissection. DeBakey developed aortic dissection himself at age 97 in and underwent surgery in Blood pressure control, diseccoon smoking .
Neurological complications of aortic dissection i. These individuals have diesccion self-selected as survivors of the acute episode and can be treated with medical therapy as long as they are stable. The high pressure rips the tissue of the media apart along the laminated plane splitting the inner two-thirds and the outer one-third of the media apart.
However, type B dissections are not improved, from a mortality point of view, by the operation, unless leaking, rupture, or compromise to other organs, e. Common disexcion used to diagnose an aortic dissection include a CT scan of the chest with iodinated contrast material and a transesophageal echocardiogram. Aortic dissection is relatively rare, occurring at an estimated rate of three qorticapeople per year.
The force of the blood entering the media causes the tear to extend.