Chapter 24 Acute Aortic Dissection and Repair

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What is the most commonly used classification system to differentiate between the regions of aortic dissection?

Jones classification system

Miller classification system

Stanford classification system (correct)

Schwartz classification system

What is the estimated percentage of patients who develop an aortic dissection and have hypertension?

50%

70% (correct)

40%

60%

What is the goal of medical management for Stanford type B aortic dissection?

To decrease the mechanical stress on the aortic wall (correct)

To increase systolic blood pressure

To promote aortic rupture

To avoid surgical intervention

What is the procedure most commonly used to correct the Stanford type B aortic dissection?

Open surgical repair of the aorta (A) Signup and view all the answers

What is the main reason for the high degree of wall tension within the aorta?

Constantly high pressure exposure (D) Signup and view all the answers

Which diagnostic data indicates a possible electrolyte imbalance?

Electrolytes level (B) Signup and view all the answers

What is the most likely cause of the patient's sharp chest pain that radiates to his upper back?

Ascending aortic dissection (B) Signup and view all the answers

Which past surgical history factor may have contributed to the current condition?

Coronary artery bypass grafting 1 year ago (A) Signup and view all the answers

What percentage of patients with acute aortic dissection are initially misdiagnosed?

50% (D) Signup and view all the answers

Which symptom is less common in acute aortic dissection patients?

Hypotension (A) Signup and view all the answers

What is the most common comorbidity associated with acute aortic dissection?

Hypertension (D) Signup and view all the answers

What treatment is recommended for hypotension in patients with acute aortic dissection?

Nitrovasodilators (C) Signup and view all the answers

What is one of the reasons for allowing the blood pH to be more alkaline during hypothermia?

To increase cerebral auto-regulation (D) Signup and view all the answers

Why should the rewarming process after hypothermia be slow?

To reduce cerebral hyperthermia and associated cerebral injury (A) Signup and view all the answers

What is a physiologic alteration associated with deep hypothermia?

Decreased organ metabolic rate of oxygen consumption (D) Signup and view all the answers

What is a postoperative anesthetic concern after acute aortic dissection repair?

Continuous use of vasoactive medication (C) Signup and view all the answers

What is the method by which circulatory arrest occurs during deep hypothermic circulatory arrest (DHCA) in aortic dissection surgery?

The cardiopulmonary bypass machine is turned off, stopping perfusion to the entire body (B) Signup and view all the answers

What is the purpose of utilizing cerebral perfusion via the cardiopulmonary bypass machine in aortic dissection surgery?

To decrease the cerebral metabolic rate of oxygen consumption (D) Signup and view all the answers

Which measure is used to protect the brain during deep hypothermic circulatory arrest (DHCA) in aortic dissection surgery?

Packing the head in ice to provide additional cooling (B) Signup and view all the answers

What is the role of intraoperative electroencephalography (EEG) in aortic dissection surgery?

To assess neurologic function (D) Signup and view all the answers