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Flashcards in Management of Aortic Dissection Deck (17)
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1


Acute disection of the ascending aorta are considered?


surgical emergencies

2


Dissection confined to the descending aorta are


treated medically unless the patient the Pt demonstrates pragressive dissection or continued hemorrhage

3


Acute management of an aortic disection is


SBP reduction to 100-120 or as low as tolerated

4


Initial medical management would be a


Beta Block to keep HR below 60

propranolol or labetolol

esmolol in acute setting

verapimil / cardazem if unable to tolerate a Beta Blocker ie. asthma or HF

5


BP control is managed through


Nipride or Nitro

6


Which medication should be avoided for vasodilation


hydralizine as it increases aortic wall shear stress

7


What Daily and DeBakey type is treated medically


Type B or Type III

8


What is the relative containdication to surgical of the ascending aortic disection


Hemorrhagic CVA

9


Poor prognosis for surgical intervention include


Over 70 yrs of age

abrupt onset of pain

hypotension, shock, tamponade

Renal failure

pulse deficit

Abnormal EKG w ST elevation

Prior MI

aortic valve replacement

 

10


CAD is present in most dissections so angiography is suggested to preform what while fixing the disection


CABG

11


Endovascular stent grafts are used on what tye of disections


Type B Daily classification

12


the stent graft is use to do what with repairing the disection


cover the intimal flap and seal the entry site causing thrombosis of the false lumen

13


a hybrid approach to type A Daily disections is the


frozen elephant trunk repair

uses an open approach to the ascending disection and a stent graft to the descenting aorta

14


Long term maagement entails


medical therapy to prevent shear stress

serial imaging for progression

reoperation when indicated

15


suggested long term medical management for BP is a tagert BP of less than


120/80

16


Suggested imaging is


MRI at 3, 6, and 12 months

17


Reopening occurs in


12-30 % usually R/T extension or recurrence of disection