Interv Akut Kardiol. 2021;20(4):199-209 | DOI: 10.36290/kar.2021.037

Acute aortic syndrome: a current viewpoint of diagnosis and treatment

Petr Vařejka

Národný ústav srdcových a cievnych chorob, a. s., Bratislava

Acute aortic syndrome (AAS) encompasses a group of severe, life-threatening conditions characterized by impaired aortic wall integrity and possible occurrence of fatal aortic haemorrhage. This group of diseases comprises acute aortic dissection (AAD), intramural haematoma (IMH), penetrating aortic ulcer (PAU), and symptomatic thoracic aorta aneurysm (TAA). Although it is a heterogeneous group of diseases, their common, though non-specific, feature is pain in the chest or back which is manifested at the outset as the chief complaint. Timely and correct diagnosis is essential for an appropriate treatment strategy which involves open surgery in the case of involvement of the ascending aorta, endovascular surgery in the case of complicated involvement of the descending aorta, and conservative medical therapy in uncomplicated cases with involvement of the descending thoracic aorta. Recently, there has also been development of combined, or hybrid, procedures consisting of a surgical and an endovascular part, particularly in conditions with involvement of the aortic arch and ascending aorta. The patient with acute aortic syndrome always requires a diagnostic-therapeutic procedure on an urgent basis and should be referred to specialized centres where multidisciplinary aortic teams are available. The present paper provides a summary of current knowledge of this issue which represents a serious medical problem, sometimes referred to with some exaggeration as "vascular catastrophe".

Keywords: acute aortic syndrome, acute aortic dissection, intramural haematoma, penetrating aortic ulcer, thoracic aorta aneurysm.

Published: November 23, 2021  Show citation