Aortic dissection: diagnosis, state-of-the-art of imaging and new management acquisitions.
A prompt diagnosis is the cornerstone of effective treatment of aortic dissection and it is the single most important determinant of survival in this patient population. New imaging modalities such as transesophageal echocardiography, magnetic resonance imaging, helical computed tomography and electron-beam computed tomography have been introduced during the last decade. These new imaging techniques allow for a better and earlier diagnosis of aortic diseases even in emergency situations. Bearing in mind the high overall mortality of aortic dissection, the role of prevention cannot be overstressed. The main risk factor for aortic dissection/rupture is the aortic diameter; therefore we would like to stress the role of aortic replacement as an effective preventive method for aortic dissection/rupture. Determining the right time for elective surgery, when the operative risk is lower than the risk of dilation-related complications, could contribute to a decrease in urgent surgical procedures on the ascending aorta.
Mariani
Massimo A
MA
Department of Cardio Thoracic Surgery, University Hospital, Pisa, Italy. massimo_mariani@hotmail.com
D'Alfonso
Alessandro
A
Nardi
Carmela
C
Codecasa
Riccardo
R
Cocchieri
Riccardo
R
Grandjean
Jan G
JG
D000784:Aortic Dissection / Q000175:diagnosis* / Q000401:mortality; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis; D017023:Coronary Angiography / Q000379:methods; D003952:Diagnostic Imaging / Q000592:standards* / Q000639:trends; D042241:Early Diagnosis; D017548:Echocardiography, Transesophageal / Q000379:methods; D005260:Female; D005544:Forecasting; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods; D008297:Male; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D015996:Survival Rate; D014057:Tomography, X-Ray Computed / Q000379:methods; D018084:Ultrasonography, Interventional