Get Acute aortic disease PDF

By John Elefteriades

ISBN-10: 084937023X

ISBN-13: 9780849370236

Masking the pathophysiology, imaging, prognosis, and therapy of a number of aortic aneurysms and dissections, this resource is helping physicians successfully research and assessment affected participants in medical or emergency care settings. delivering a big selection of illustrations, x-rays, and operative images to stress key anatomic observations, this advisor comprises state of the art perception at the most recent biologic, radiologic, scientific, and surgical advancements that experience taken position within the box. offered in a reader-friendly layout, this resource offers end-of-chapter questions and a point-counterpoint layout to research differing views from well known specialists on those illnesses. The Q

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Example text

Types I and II require urgent surgical repair with an interposition graft, a conduit, or even associated hemi-arch or arch reconstruction. Conversely, Type III DeBakey dissection appears less life threatening and may be followed conservatively, or subjected to nonsurgical stent-graft repair (40). Figure 1 The most common classification systems of thoracic aortic dissection— the Stanford and DeBakey classifications. indd6 6 2/14/2007 5:51:15 PM Classification of Aortic Dissection 7 Stanford Classification The original Stanford classification described by Daily et al.

Indeed, if all of the patients with aortic dissection presented in such a “classic” fashion, aortic dissection could be easily distinguished from other acute syndromes and thus be more promptly diagnosed. Unfortunately, in reality, only a minority of patients with aortic dissection actually present with fully classic symptoms and signs; rather, the majority present with less typical symptoms and often few, if any, of the classic signs. Moreover, the mix of symptoms and signs are often quite varied, so that even experienced clinicians find diagnosing aortic dissection consistently challenging.

Similar pathogenetic processes have been described with coarctation (18) and with the bicuspid aortic valve architecture (19) (Table 1). Chronic Hypertension and Atherosclerosis Chronic hypertension affects the arterial wall composition, causing intimal thickening, fibrosis, calcification, and extracellular fatty acid deposition. In parallel, the extracellular matrix undergoes accelerated degradation, apoptosis, and elastolysis, with hyalinization of collagen. Both mechanisms may eventually lead to intimal disruption, most often at the edges of plaques (as seen in coronary plaques, as well).

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Acute aortic disease by John Elefteriades

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