Discuss the aortic dissection assignment

Discuss the aortic dissection assignment
How would you classify the aortic dissection?
A. Stanford A dissection.
B. Stanford B dissection.
C. de Bakey I dissection.
D. de Bakey II dissection.
E. de Bakey III dissection
On the same day, she underwent an emergency operation. The dissected ascending aorta with the entry of dissection was incised in a cardiopulmonary bypass and
replaced by a graft using the in-graft technique. The aortic valve was patent and
remained in situ. For reconstruction of the aortic root, the sandwich technique was
used. Two Teflon strips were placed externally and into the true lumen to reattach
the dissected membrane to the aortic wall. The aortic graft was then sutured into the
reconstructed aortic root.
Dissection: Stanford A
Question 2
Which of the following statements are wrong?
A. Stanford A dissections should be treated medically.
B. Stanford A dissections should undergo operation immediately.
C. Stanford B dissections without ischaemic complications should be treated medically.
D. Stanford B dissections require operative intervention immediately.
E. Stanford A dissections require an aortic stent graft immediately.
The postoperative course was uneventful at the beginning. However, 3 days later,
renal function deteriorated and the patient required haemofiltration. Moreover, the
patient developed severe hypertension and had to be treated with three different
antihypertensive drugs. Contrast CT scans revealed that the right kidney was
without function due to an old hydronephrosis, while the left renal artery was probably dissected. Furthermore, the patient developed left leg ischaemia and was transferred to our centre. We explored the abdomen via the transperitoneal approach.
The pulsation of the left iliac artery was weak due to aortic and left iliac dissection.
Infrarenal aorto-iliac membrane resection was performed to restore the blood flow
to the extremities. Then the left renal artery was explored; the renal artery dissection was found to extend towards the hilus of the kidney.
Revascularisation was achieved with a saphenous vein interposition graft placed
between the left iliac artery and the distal left renal artery (Fig. 6.1).
Question 3
Which of the following statements are correct?
A. Complications of Stanford A dissection are aortic valve insufficiency and perforation into the pericardium.
B. Stroke is a typical complication of Stanford B dissection.
C. Paraplegia is a typical complication of aortic dissection.
D. Most patients with Stanford B dissections die of aortic perforation.
E. Typical complications of aortic di