CẬP NHẬT CHẨN ĐOÁN VÀ ĐIỀU TRỊ BỆNH LÝ ĐỘNG MẠCH CHỦ

CẬP NHẬT CHẨN ĐOÁN VÀ ĐIỀU
TRỊ BỆNH LÝ ĐỘNG MẠCH CHỦ
Nguyễn Hưng Trường, MD
Nguyễn Hoàng Định, A/Prof



NORMAL ANATOMY,
ABNORMAL
ANATOMY, AND DEFINITIONS


NORMAL AORTIC ANATOMY


AORTIC LANDING ZONES


DEFINITIONS AND
CLASSIFICATION OF ACUTE
AORTIC SYNDROME (AAS)
AAS are life-threatening conditions in which there is a
breach in the integrity of the aortic wall. The most
common AAS are aortic dissection, intramural
hematoma (IMH), and penetrating atherosclerotic
ulcer (PAU), all of which can lead to rupture.




CLINICAL SIGNS AND SYMPTOMS

AAS


MALPERFUSION SYNDROME


ACUTE AORTIC
SYNDROME (AAS)


MEDICAL
MANAGEMENT
OF AAS


AORTIC DISSECTION

• The dissection flap can propagate in an antegrade or retrograde fashion
and lead to a number of life-threatening complications, including acute
aortic regurgitation (AR), myocardial ischemia, cardiac tamponade,
acute stroke, or malperfusion syndromes.
• The blood surging in the false lumen may rupture back through the
intima into the true lumen, creating a reentry tear. If the blood in the false
lumen instead tears through the outer media and adventitia, aortic
rupture will result.



MALPERFUSION
(giảm tưới máu tạng)

Any of the aortic branches are at risk for
malperfusion as the false lumen expands and
compresses the true lumen and can occur in
multiple vascular beds simultaneously as the
dissection propagates distally.




SURGICAL AND ENDOVASCULAR
MANAGEMENT OF
ACUTE AORTIC DISSECTION
 Surgical and Endovascular Management of Acute
Aortic Dissection



MANAGEMENT OF ACUTE
TYPE B AORTIC DISSECTION