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Online ISSN 1827-1847
THE MANAGEMENT OF THORACIC TYPE A DISSECTIONS
Department of Cardiothoracic Surgery, Royal Brompton Hospital, Sydney St, London, UK
Aortic dissection is an uncommon but potentially fatal disease with catastrophic complications. A high level of suspicion is required for successful diagnosis because the presenting symptoms are so variable that dissection may be overlooked in up to 40% of cases. It most commonly presents in the elderly population with a history of chronic hypertension. Rapid intervention is necessary as delay leads to higher mortality. Despite advances in diagnostic and therapeutic techniques, morbidity and mortality remains high. Advances in diagnostic imaging have raised awareness of variants of aortic dissection, such as intramural haemorrhage and penetrating aortic ulcer. This distinction is important as the clinical course of these variants differs from classical aortic dissection, and thus treatment may also differ.