Read more about this disease, some with Classification – Types – Signs and symptoms – Genetics – Pathophysiology – Diagnosis – Screening – Prevention – Treatment and management – Cures and much more, some including pictures and video when available.
Aortic dissection is a tear in the wall of the aorta that causes blood to flow between the layers of the wall of the aorta and force the layers apart.[1] Aortic dissection is a medical emergency and can quickly lead to death, even with optimal treatment. If the dissection tears the aorta completely open (through all three layers), massive and rapid blood loss occurs. Aortic dissections resulting in rupture have an 80% mortality rate, and 50% of patients die before they even reach the hospital. If the dissection reaches 6 cm, the patient must be taken for emergency surgery. The surgery to repair a dissection takes about 20 hours. The patient would be in a drug induced coma for three days.[2]
As with all other arteries, the aorta is made up of three layers. The layer that is in direct contact with the flow of blood is the tunica intima, commonly called the intima. This layer is made up of mainly endothelial cells. The next layer is the tunica media, known as the media. This “middle layer” is made up of smooth muscle cells and elastic tissue. The outermost layer (furthest from the flow of blood) is known as the tunica adventitia or the adventitia. This layer is composed of connective tissue.
In an aortic dissection, blood penetrates the intima and enters the media layer. The high pressure rips the tissue of the media apart, allowing more blood to enter. This can propagate along the length of the aorta for a variable distance, dissecting towards or away from the heart or both. The initial tear is usually within 100 mm of the aortic valve.
The risk in aortic dissection is that the aorta may rupture, leading to massive blood loss resulting in death.
Several different classification systems have been used to describe aortic dissections. The systems commonly in use are either based on the anatomy of the dissection or the duration of onset of symptoms prior to presentation.
The DeBakey system, named after surgeon and aortic dissection sufferer Michael E. DeBakey, is an anatomical description of the aortic dissection. It categorizes the dissection based on where the original intimal tear is located and the extent of the dissection (localized to either the ascending aorta or descending aorta, or involves both the ascending and descending aorta.[3]
[tubepress mode=’tag’, tagValue=’Aortic dissection’]