Skip Navigation

Continuing Education in Anaesthesia, Critical Care & Pain 2009 9(1):14-18; doi:10.1093/bjaceaccp/mkn044
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow CME/CE:
Take the course for this article:
 CEACCP, Volume 9 – Issue 1, Febr...
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by Hebballi, R.
Right arrow Articles by Swanevelder, J.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Hebballi, R.
Right arrow Articles by Swanevelder, J.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?


© The Board of Management and Trustees of the British Journal of Anaesthesia [2009]. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Diagnosis and management of aortic dissection

Ravi Hebballi, MD FRCA FCARCSI
Clinical Fellow in Cardiothoracic Anaesthesia
University Hospitals of Leicester NHS Trust
Glenfield Hospital
Leicester LE3 9QP, UK

Justiaan Swanevelder, MB ChB MMed(Anes) FCA(SA) FRCA
Consultant Anaesthetist
University Hospitals of Leicester NHS Trust
Glenfield Hospital
Leicester LE3 9QP, UK
Tel: +44 0116 2503454 Fax: +44 0116 2314791 E-mail: justiaan.swanevelder@uhl-tr.nhs.uk

The first 150 words of the full text of this article appear below.


Key points

Aortic dissection can be easily missed. A high index of suspicion is important in patients who have predisposing risk factors.
Classification is based on the location of dissection and its duration. Stanford type A dissections require surgery; type B dissections may be managed non-surgically under most conditions.
Multiple diagnostic imaging modalities can be used to complement each other depending upon the availability of facilities and patient condition.
Anaesthetic management of these patients is challenging because of significant haemodynamic instability.
Chances of survival are improved with prompt diagnosis, blood pressure and heart rate control, and early surgical repair if indicated.

 

Aortic dissection is a rare but potentially fatal event resulting in separation of the layers of the tunica media by ingress of blood, producing a false lumen with variable proximal and distal extension. Ascending aortic dissection is the most common catastrophe of the aorta; it is 2–3 times more . . . [Full Text of this Article]


   Classification
 
Stanford classification

DeBakey classification


   Pathophysiology
 

   Clinical features
 

   Diagnosis
 
Imaging


   Initial management
 
Surgical management

Anaesthetic considerations

Type A dissection

Monitoring and lines

Induction and maintenance

Cannulation options and cardiopulmonary bypass

Cerebral protection

Temperature regulation

Coagulation

Pain relief

Type B dissection


   Postoperative management
 

   Interventional management
 

   Medical management
 

   Prognosis and follow-up
 

Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?