How should we manage type A aortic dissection?
Treatment for type A aortic dissection may include:
- Surgery. Surgeons remove as much of the dissected aorta as possible and stop blood from leaking into the aortic wall.
- Medications. Medications are given to reduce heart rate and lower blood pressure, which can prevent the aortic dissection from worsening.
What is a Stanford type A aortic dissection?
In the Stanford classification of aortic dissection: Type A involves the ascending aorta and may progress to involve the arch and thoracoabdominal aorta. Type B involves the descending thoracic or thoracoabdominal aorta distal to the left subclavian artery without involvement of ascending aorta.
What is Stanford classification?
Stanford Classification. The Stanford classification divides aortic dissection into two groups, A and B: Group A – includes DeBakey Types I and II and involves the ascending aorta and can propagate to the aortic arch and descending aorta; the tear can originate anywhere along this path.
Which drug is used to manage a patient with a dissecting aneurysm?
Beta Blockers and Other Antihypertensive Medications Beta blockers are often the first treatment for a type B aortic dissection. These medications reduce blood pressure by blocking the effects of the hormone epinephrine, or adrenaline. This relaxes the heart, slowing it down.
What is type A dissection?
Type A dissection occurs when the tear develops in the ascending part of the aorta just as it branches off the heart, while Type B dissection involves the lower aorta. While Type A dissection is the more dangerous form, chances of survival are significantly improved with early detection and management.
How long can you live with a type A aortic dissection?
1 Introduction. Acute type A aortic dissection (AAD) is a life-threatening emergency that carries a high mortality rate without surgical treatment [1,2]. Surgical mortality has been estimated to range from 9% to 30%, and survival rates of 51–82% at 5 years have been reported [3–9].
Why are beta blockers first line for aortic dissection?
Beta blockers are often the first treatment for a type B aortic dissection. These medications reduce blood pressure by blocking the effects of the hormone epinephrine, or adrenaline. This relaxes the heart, slowing it down. Less blood leaves the heart, and it leaves with less force.
Why is labetalol used in aortic dissection?
EDITOR,—Adrian P Banning and colleagues state that labetalol is the drug of choice to control arterial pressure in patients with suspected dissection of the thoracic aorta. 1 Labetalol is an appropriate hypotensive agent in certain circumstances but is disadvantaged by its relatively long half life (3-5 hours).
What causes type A aortic dissection?
An aortic dissection is caused by a weakened area of the aorta’s wall. Aortic dissections are divided into two groups, depending on which part of the aorta is affected: Type A. This more common and dangerous type involves a tear in the part of the aorta where it exits the heart.
How long can a person live with an aortic dissection?
Acute type A aortic dissection (AAD) is a life-threatening emergency that carries a high mortality rate without surgical treatment [1,2]. Surgical mortality has been estimated to range from 9% to 30%, and survival rates of 51–82% at 5 years have been reported [3–9].
What is the success rate of AAA surgery?
Surgical procedures for the repair of abdominal aortic aneurysms have a high success rate, with more than 95 percent of patients making a full recovery.
Do you give aspirin in aortic dissection?
Pain Medications. If controlling blood pressure doesn’t reduce the pain from a dissection, doctors may prescribe pain medication, such as acetaminophen or a nonsteroidal anti-inflammatory drug. Taking aspirin, which can cause bleeding, can be fatal in someone with an aortic dissection and is never advised.
Which beta blocker is best for aortic dissection?
Intravenous propranolol, metoprolol, labetalol, or esmolol are suggested as excellent choices for initial treatment. In patients who are unable to tolerate beta-blockade, non-dihydropyridine calcium channel antagonists (verapamil, diltiazem) were suggested to offer acceptable, although less-established, alternatives.
Why is nitroprusside used in aortic dissection?
These agents are used to reduce arterial dP/dt. For acute reduction of arterial pressure, the potent vasodilator sodium nitroprusside is effective. To reduce dP/dt acutely, administer an IV beta-blocker in incremental doses until a heart rate of 60-80 beats/min is attained.