Surgical management of acute aortic dissection

Abstract

Acute or chronic aortic dissections still represent a major challenge for the clinician. Despite its rarity, management is not easy, generally resulting in a bad short-term prognosis. Yet, recent studies based on the International registry of acute aortic dissection assessed clinical tools to help the clinician identifying the various presentations of aortic dissection. Emergency diagnosis relies on specific imaging including transesophageal echocardiography and computed tomography. Emergent surgical treatment is mandatory when the dissection involves the ascending aorta. Once the critical phase treated, the aortic dissection usually progresses to a chronic disease with aneurismal transformation and risks of tearing in the remaining dissected aorta, leading to significant mid- and long-term morbidity and mortality. Therefore patients previously treated for aortic dissection have to be tightly monitored during their whole life and rapidly reoperated if required.