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MedenoSrce - Aortna disekcija (2008)

Aortna disekcija (2008)

Datoteke:
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Snemi datoteko (aortna_dissekcija.doc)aortna_dissekcija.doc72 kB
Izvleček: Aortna dissekcija je nujno stanje, ki se prične z zatrganjem intime in notranje plasti medije, hematom se lahko širi anterogradno ali retrogradno. Najbolj uveljavljena je razvrstitev po Stanford-u, pri kateri poznamo aortne disskecije tipa A (prizadeta je ascendentna aorta) in tipa B (prizadeta je descendentna aorta). Poglavitna dejavnika za nastanek dissekcije sta arterijska hipertenzija ter patološko spremenjena medija pri različnih boleznih. Diagnozo postavimo s pomočjo klinične slike in slikovnih diagnostičnih preiskav, najpogosteje računalniške tomografije ter transezofagealne ehokardiografije. Pomembno je konzervativno zdravljenje povišanega krvnega pritiska ter operativni poseg pri tipu A aortne dissekcije in tipu B s pretečimi zapleti. Z endoanevrizmorafsko metodo se vstavi umetna žilna proteza. Manj invaziven poseg, ki pride v poštev pri tipu B dissekcije, je endovaskularno vstavljanje žilnih opornic (stent graft implantation).

Ključne besede: aorta, dissekcija, žilna proteza, žilna opornica, transezofagealna ehokardiografija

Abstract: Aortic dissection is an emergency condition, which starts with a rupture in intima and inner layers of media, hematoma can spread either forwards or backwards. According to Stanford classification, there are two types of aortic dissection: type A (when ascendent aorta is involved) and type B (when descendent aorta is involved). Main factors in etiology of aortic dissection are arterial hypertension and pathologically changed media during course of other diseases. Diagnosis is made on a basis of clinical picture and imaging studies, especially computer tomography and transesophageal echocardiography. It is important to treat high blood pressure medically and to perform surgical procedure in case of type A dissection and type B with threatening complications. A blood vessel graft is inserted where aorta has initial tear. Less invasive procedure is endovascular stent graft implantation.

Key words: aorta, dissection, vessel graft, stent graft, transesophageal echocardiography