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Surgical Strategies in Acute and Chronic Type B Aortic Dissection

  • Mark FieldEmail author
  • Debbie Harrington
  • Omar Nawaytou
  • Manoj Kuduvalli
Chapter

Abstract

Type B aortic dissection, whether acute or chronic, is a challenging disease to manage successfully. The acute disease often presents as a complex range of pathologies, described as the acute aortic syndrome, often occurring as acute on chronic thoracoabdominal disease. This complexity makes acute Type B aortic dissection a challenging and rewarding condition to manage. Unlike acute Type A dissection, the primary objective of acute Type B aortic dissection is to steward or shepherd the patient into a chronic state with good medical management.

This may include simple medical control of blood pressure through to endovascular management of malperfusion syndromes or impending rupture. On occasions where life is threatened and there are no endovascular options, high-risk surgery may be the only option. Once successfully managed into the chronic state, intervention may be considered in the elective setting based on size, symptoms or expansion. Thoracoabdominal aortic surgery, even in the elective setting, requires experienced multidisciplinary teams to achieve successful outcomes.

Keywords

Acute aortic syndrome Dissection Surgery Endovascular Malperfusion Management 

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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2019

Authors and Affiliations

  • Mark Field
    • 1
    Email author
  • Debbie Harrington
    • 1
  • Omar Nawaytou
    • 1
  • Manoj Kuduvalli
    • 1
  1. 1.Thoracic Aortic Aneurysm ServiceLiverpool Heart and Chest HospitalLiverpoolUK

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