Diagnosis and Treatment of Aortic Diseases
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Developments in Cardiovascular Medicine VOLUME 212
The titles published in this series are listed at the end of this volume.
Diagnosis and Treatment of Aortic Diseases editedby
CHRISTOPH A. NIENABER Department of Cardiology, University Hospital Eppendorf, Hamburg, Germany
and ROSSELLA FATTORI Institute of Radiology and Cardiac Surgery, University Hospital S. Orsola, Bologna, Italy
SPRINGER SCIENCE+BUSINESS MEDIA, B.V.
Library of Congress Cataloging-in-Publication Data Oiagnosis and treatment of aortic diseases / edited by Christoph A. Niehaber, Rossella Fattori. p. c •. -- (Oevelopaents in cardiovascular medicine ; 212) Includes blbl10graphlcal references and Index. ISBN 978-94-010-6024-0
ISBN 978-94-011-4828-3 (eBook)
DOI 10.1007/978-94-011-4828-3
1. Nlenaber, Chrlstoph 1. Aorta--Oiseases. 2. Aorta--Surgery. II. Fattorl, Rossella. III. Ser les. [ONLM: 1. Aortlc 01seases--dlagnosls. 2. Aortlc 01seases-therapy. WG 410 05353 19991 RC691 .0485 1999 616. 1 '38--dc21 ONLM/OLC for Llbrary of Congress 98-49373 A.
ISBN 978-94-010-6024-0
Printed an acid-free paper
AII Rights Reserved
© 1999 Springer Science+Business Media Dordrechl
Originally published by Kluwer Academic Publishers in 1999 Softcover reprint of the hardcover 1st edition 1999
No part of the material protectec\ by this copyright notice may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording or by any information storage and retrieval system, without written permission from the copyright owner
Table of Contents
xi
List of Contributors Foreword by Hans B. Borst
1
Preface by the editors
3
1.
Aortic Dissection Christoph A. Nienaber
1.1. 1.2. 1.3. 1.4. 1.5. 1.6. 1.6.1. 1.6.2. 1.6.3. 1.6.4. 1.6.5. 1.7. 1.7.1. 1.7.2. 1.7.3. 1.7.4. 1.7.5. 1.7.6. 1.7.7. 1.7.8. 1.8.
Introduction Definition Etiology and pathogenesis Classification Clinical presentation Diagnosis Magnetic resonance imaging Echocardiography Computed tomography The optimal diagnostic approach Coronary angiography in aortic dissection Management of acute aortic dissection Medical treatment Treatment of cardiac tamponade Management of malperfusion Chronic medical treatment Surgical treatment of aortic dissection Technical aspects of surgery Repair of the aortic arch Follow-up strategy References
2.
Aortic Aneurysm Arturo Evangelista, lordi-Soler-Soler, Herminio Garcia Del Castillo, Carmen Sebastia, and Rosa Dominguez v
5 5 6 6 11 11 15 18 24 27 27 32 32 33 34 35 36
38 43 44 45 48
57
vi
TABLE OF CONTENTS
2.1. Etiology 2.1.1. Atherosclerosis 2.1.2. Ulcer 2.1.3. Cystic medial degeneration 2.1.4. Trauma 2.1.5. Infectious aortitis 2.1.6. Noninfectious aortitis 2.1.7. Congenital aneurysm 2.2. Pathophysiology 2.3. Diagnostic approach 2.3.1. Clinical presentation and physical examination 2.3.2. Imaging modalities 2.3.2.1. Ultrasound 2.3.2.2. Angiography 2.3.2.3. Computed tomography 2.3.2.4. Magnetic resonance imaging 2.3.2.5. Current diagnostic approach 2.3.3. Pathology 2.3.3.1. Intraoperative and necropsy findings 2.
