Separating the false lumen from the true lumen is a layer of intimal tissue known as the intimal flap.The vast majority of aortic dissections originate with an intimal tear in either the ascending aorta (65%), the aortic arch (10%), or just distal to the ligamentum arteriosum in the descending thoracic aorta (20%).As blood flows down the false lumen, it may cause secondary tears in the intima. Through these secondary tears, the blood can re-enter the true lumen.While it is not always clear why an intimal tear may occur, quite often it involves degeneration of the collagen and elastin that make up the media. This is known as cystic medial necrosis and is most commonly associated with Marfan syndrome and is also associated with Ehlers-Danlos syndrome.In about 13% of aortic dissections, no evidence of an intimal tear is found. In these cases, the inciting event is thought to be an intramural hematoma (caused by bleeding within the media). Since no direct connection exists between the true lumen and the false lumen in these cases, diagnosing an aortic dissection by aortography is difficult if the cause is an intramural hematoma. An aortic dissection secondary to an intramural hematoma should be treated the same as one caused by an intimal tear. Diagnosis
Because of the varying symptoms of aortic dissection, the diagnosis is sometimes difficult to make.
He underwent 10+1⁄2 hours of open heart surgery to repair the aortic dissection.In May 2022, keyboardist Andy Fletcher, a founding member of the UK band Depeche Mode, died unexpectedly at home from an aortic dissection, at the age of 60. See also
Carotid artery dissection
Vertebral artery dissection

References


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