Annals of Cardiovascular and Thoracic Surgery

Annals of Cardiovascular and Thoracic Surgery 44 7897 074717

Thrombosed Type A Acute Aortic Dissection

Thrombosed type A acute aortic dissection is a specific type of aortic dissection. The incidence of TA AAD is not unusual disease, and it ranges from 3 to 33 % in entire cases of type A AAD. Lately, TA AAD became detected more frequently by the help of advanced imaging devices. The computed tomographic finding of this disease is a crescent-shaped false lumen without any entry sites and obvious blood flow in the false lumen. The pathogenesis of TA AAD remains unclear. Spontaneous rupture of the aortic vasa vasorum is one of the pathogenic mechanisms for so-called “aortic dissection without tear” or “intramural hematoma (IMH)”, which was mainly proposed in the western countries. Alternative mechanism is the fake lumen thrombosis rapidly later the intimal tear develops probably because lack of re-entry. Lately, Park and partners showed that a large proportion of IMH has intimal tear at ascending aorta or arch, which is the similar pathogenesis as classical aortic dissection.

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