Volume 1 - Issue 2
Kanimozhi A1*, Reena Ignatius2, Cesilipriya S3, Sri Ranjani4, Sathiya5
1Assistant Manager (Operation Theatre), Kauvery Heartcity, Trichy, India
2Nurse Educator, Kauvery Heartcity, Trichy, India
3Nursing Incharge, Kauvery Heartcity, Trichy, India
4Senior staff nurse, Kauvery Heartcity, Trichy, India
5Senior staff nurse, Kauvery Heartcity, Trichy, India
An aortic dissection is a medical emergency in which a tear occurs in the inner layer of the body's main artery (aorta). It's most common in men in their 60s and 70s. Blood rushes through the tear, causing the inner and middle layers of the aorta to split (dissect). If the blood goes through the outside aortic wall, aortic dissection is often deadly.
The aorta is the main artery which branches off the heart and supplies oxygen-rich blood to the body's organs and tissues. The wall of the aorta consists of inner, middle and outer layers. Aortic dissection occurs when there is a tear in the inner layer, which allows blood to enter through the tear and fill up between the inner and middle layers, causing these layers to separate or 'dissect'.
Stanford classification of aortic dissection:
Acute Type-A aortic dissection is a life-threatening emergency that carries a high mortality rate without surgical treatment. Surgical mortality has been estimated to range from 9% to 30% and survival rates of 51% to 82% at 5yrs. Short-term and long-term survival rates after acute type A aortic dissection are unknown. Previous studies have reported survival rates between 52% and 94% at 1 year and between 45% and 88% at 5 years.
Fig 1: Classification of Aortic Dissection.
A 29 years old male who was euglycemic and normotensive came to the hospital with the complaints of breathlessness and orthopnea for past 10day for which he went to outside hospital initially. There, he was diagnosed to have severe left ventricular dysfunction and congestive cardiac failure, and referred here for further management.
On admission, His vital signs were;
Temp - 98.6F, Pulse -88bpm, Respiration -22bpm, B.P -130/90 mm of Hg.
Urine Output was found to be adequate.
He underwent ECG, ECHO, X RAY and CT Angiography.
ECHO findings: Type A aortic dissection, severe aortic regurgitation, poor left ventricular function (EF30 %), mild Mitral regurgitation, severe Tricuspid regurgitation and moderate Pulmonary Artery Hypertension. EF-30%.
CT Angiography findings: Aneurysmal dilatation of aortic root and ascending aorta, Stanford Type-A dissection and ground glass opacities with inter lobar septal thickening in bilateral lower lobes.
He was diagnosed to have Type A Aortic Dissection and was planned for emergency Aortic dissection repair and Right atrial thrombectomy on 20-06-2022.
Immediate postoperative care
After surgery many patients may expect a relatively good short-term outlook.
Patient was hemodynamically stable, status and condition improved, and was discharged on 11th post operative day.
Assistant Manager (OT)
Senior Staff Nurse
Senior Staff Nurse