[PBL] Treatment of Aortic Dissection(대동맥박리)(영문)

[PBL] Treatment of Aortic Dissection(대동맥박리)(영문)-3

[PBL] Treatment of Aortic Dissection(대동맥박리)(영문)-4

[PBL] Treatment of Aortic Dissection(대동맥박리)(영문)-5

[PBL] Treatment of Aortic Dissection(대동맥박리)(영문)-6

[PBL] Treatment of Aortic Dissection(대동맥박리)(영문)-7

[PBL] Treatment of Aortic Dissection(대동맥박리)(영문)-8

[PBL] Treatment of Aortic Dissection(대동맥박리)(영문)-9

[PBL] Treatment of Aortic Dissection(대동맥박리)(영문)-10

[PBL] Treatment of Aortic Dissection(대동맥박리)(영문)-11

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2010.08.14
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소개글

[PBL] Treatment of Aortic Dissection(대동맥박리)(영문)에 대한 자료입니다.

1. Acute or Chronic ?

2. Location ?

3. Complicated ?

본문내용

Medical treatment
< Indication >
Uncomplicated Type B
Chronic Aortic dissection
Stable dissection isolated to Aortic arch

< Objective >
Control high blood pressure, if present.
Reduce the shear-force of blood from the left ventricle

< Drugs >

β-blocker + sodium nitroprusside

Ca+ channel blocker

Direct vasodilator (diazoxide, hydralazine) 은 금기 ! Tear 을 더 조장할 수 있다.

Surgical treatment
< Indication >
Type A
Acute Aortic dissection
Complicated Type B

< Objective >
Resect the most severely damaged segments of the aorta , Replace damaged section
Obliterate the entry of blood into the false lumen
Replace aortic valve (if there is damage)

< Operation > (usually combined with on-going medical management )

Bentall procedure - Replacement of the damaged section of aorta and replacement of the aortic valve.
David procedure - Replacement of the damaged section of aorta and reimplantation of the aortic valve.
Insertion of a stent graft, ex) TEVAR(thoracic endovascular aortic repair).

Follow up
If the individual has refractory hypertension (persistent hypertension on the maximum doses antihypertensive agents), involvement of the renal arteries in the aortic dissection plane should be considered.

There is a 17~25% incidence of new aneurysm formation. (due to dilatation of the residual false lumen).

These new aneurysms are more likely to rupture, due to their thinner walls.

Imaging of the aorta is suggested (MRI)

참고문헌

Pacific Cardiology. 2009. Aortic dissection.

Suziku, Toru; Hirohisa Katoh & Ryozo Nagai Biochemical diagnosis and treatment of aortic dissection. Japanese Heart Journal. 2009

Jeng Wei, A new vascular ring connector in surgery for aortic dissection. The Journal of Thoracic and Cardiovascular Surgery. 2009.

#대동맥박리 #PBL #Treatment #Dissection

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