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CC BY 4.0 · Aorta (Stamford) 2016; 04(01): 16-21
DOI: 10.12945/j.aorta.2015.15.016
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Chronic Type A Aortic Dissection

Two Cases and a Review of Current Management Strategies
Conor F. Hynes
1   Division of Cardiothoracic Surgery, Veterans Affairs Medical Center, Washington District of Columbia, USA
,
Michael D. Greenberg
2   Division of Cardiology, Veterans Affairs Medical Center, Washington District of Columbia, USA
,
Shawn Sarin
3   Department Interventional Vascular Radiology, The George Washington University, Washington District of Columbia, USA
,
Gregory D. Trachiotis
1   Division of Cardiothoracic Surgery, Veterans Affairs Medical Center, Washington District of Columbia, USA
4   Division of Cardiothoracic Surgery, The George Washington University, Washington District of Columbia, USA
› Author Affiliations
Further Information

Publication History

17 April 2015

20 October 2015

Publication Date:
24 September 2018 (online)

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Abstract

Stanford Type A aortic dissection is a rapidly progressing disease process that is often fatal without emergent surgical repair. A small proportion of Type A dissections go undiagnosed in the acute phase and are found upon delayed presentation of symptoms or incidentally. These chronic lesions may have a distinct natural history that may have a better prognosis and could potentially be managed differently then those presenting acutely. The method of repair depends on location and extent of the false lumen, as well as involvement of critical structures and branch arteries. Surgical repair techniques similar to those employed for acute dissection management are currently first-line therapy for chronic cases that involve the aortic valve, sinuses of Valsalva, coronary arteries, and supra-aortic branch arteries. In patients with high-risk for surgery, endovascular repairs have been successful, and active development of delivery systems and grafts will continue to enhance outcomes. We present two cases of chronic Type A aortic dissection and review the current literature.

Key Words

Chronic aortic dissection - Stanford Type A dissection - Thoracic endovascular aortic repair
 

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