DISSECTING ANEURYSM is a serious condition proving fatal in more than 75% of cases. The more common subacute or chronic types beginning in the descending thoracic aorta have been managed satisfactorily by resection and graft replacement for nearly a decade.1 Recent reports have described elective repair for the more extensive type of dissecting aneurysm beginning just above the aortic valve in a few fortunate patients surviving weeks or months after the onset of the dissecting process.1-6 The purpose of this report is to describe complete correction of this condition in its acute form and to illustrate the problem and its successful emergency treatment by a case report.
The process begins with a transverse tear, often circumferential, in the intimal and medial layers of the aorta just above the aortic valve (Fig 1). Through this tear the force of blood dissects the aortic wall, creating a false lumen.
Morris GC, Henly WS, DeBakey ME. Correction of Acute Dissecting Aneurysm of Aorta with Valvular Insufficiency. JAMA. 1963;184(1):63–64. doi:10.1001/jama.1963.73700140012023a
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