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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The long-term follow-up in individuals who survive aortic dissection involves strict blood pressure control. A TEE may be technically difficult to perform in individuals with esophageal strictures or varices.
Emergency Medicine Clinics of North America. Another mechanism is that the dissection may extend into aorrtica aortic root and detach the aortic disrccion leaflets. The scan then follows the contrast as it flows through the vessel. Complications include compromise of a vital organ, rupture or impending rupture of the aorta, retrograde dissection into the ascending aorta. Vascular surgerycardiothoracic surgery. Often, the diagnosis is made by visualization of the intimal flap on a diagnostic imaging test.
Establishing the incidence of aortic dissection diseeccion been difficult because many cases are only diagnosed after death which may have been attributed to another causeand is often initially misdiagnosed. Disadvantages include the need for iodinated contrast material and the inability to diagnose the site of the intimal tear. Not to be confused with Abdominal aortic aneurysm.
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Turner syndrome also increases the risk of aortic dissection, by aortic root dilatation. The procedure is known as aortography.
Retrieved 27 May Computed tomography angiography is a fast, noninvasive test that gives an accurate three-dimensional view of the aorta. The relative risk of late rupture of an aortic aneurysm is 10 times higher in individuals who have uncontrolled hypertension, compared to individuals with a systolic pressure below mmHg.
In the image to the left, the intimal flap can be seen separating the two lumens. Dissection of the descending part of the aorta 3which starts from the left subclavian artery and extends to the abdominal aorta 4. Show more Show less. In other projects Wikimedia Commons. SJR uses a similar algorithm as the Google page rank; it provides a quantitative and qualitative measure of the journal’s impact.
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. Pseudohypotension falsely low blood-pressure measurement may occur due to involvement of the brachiocephalic artery supplying the right arm or the left subclavian artery supplying the left arm.
Ultrasound of the Week. D ICD – The DeBakey system, named after cardiothoracic surgeon Michael E. Since no direct connection exists between the true lumen and the false lumen in these cases, diagnosing an aortic dissection by aortography is difficult if the cause is an intramural hematoma. It has become the preferred imaging modality for suspected aortic dissection.
Disección aórtica aguda abdominal infrarrenal | Angiología
Previously thought to be the diagnostic gold standardit has been supplanted by other, less-invasive imaging modalities. It is a noninvasive test, does not require the use of iodinated contrast material, and can detect and quantitate the degree of aortic insufficiency.
Archived from the original on 5 January Aortic dissection is more common in those with a history of high blood pressurea number of connective tissue diseases that affect blood vessel wall strength such as Marfan syndrome and Ehlers Danlos syndromea bicuspid aortic valveand previous heart surgery. 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.
Si continua navegando, consideramos que acepta su uso. Multiple causes exist for AI in the setting of ascending aortic dissection. Cardiovascular disease vessels I70—I99— Iatrogenic causes include trauma during cardiac catheterization or due to an intra-aortic balloon pump. If there is high clinical suspicion, a more sensitive imaging test CT angiogramMR angiographyor transesophageal echo may be warranted. Angiology accepts and reviews articles for publication received from Spain and Latin American countries.
In an aortic dissection, blood penetrates the intima and enters the media layer. The proximity of the aorta to the esophagus allows the use of higher-frequency ultrasound for better anatomical images.
While many institutions give sedation during transesophageal echocardiography for added patient comfort, it can be performed in cooperative individuals without the use of sedation.
Indications for the surgical treatment of aortic dissection include an acute proximal aortic aoritca and an acute distal aortic dissection with one or more complications. Aortic dissection AD occurs when an injury to the innermost layer of the aorta allows blood to flow between the layers of the aortic wall, forcing the layers apart. Common tests used to diagnose an aortic dissection include a CT scan of the chest with iodinated contrast material and a transesophageal echocardiogram. Long-term blood pressure control is required for every person who has experienced aortic dissection.
The American Journal of Cardiology. Subscriber If you already aaortica your login data, please click here. Archived from the original on 9 May The target blood aortiica should be a mean arterial pressure MAP of 60 to 75 mmHgor the lowest blood pressure tolerated.