Two-step Treatment of Patient with DeBakey Type III Dissection

Aortic dissection is part of the acute aortic syndrome. Dissection was described for the first time during the autopsy of the British king George II in the 18th C. The disease represents blood entering between the layers of the aortic wall, leading to the formation of two parts of the lumen – a true and a false one. A lot of predisposing factors threaten the aortic wall entirety and are a reason for dissection onset: arterial hypertension, hereditary connective tissue disease (Marfan, Ehlers-Danlos), atherosclerosis, vasculitis, iatrogenic factors (aortic catheterization), etc. Different classifications are used to describe the dissection type: De Bakey and Stanford. A total of 60% of dissections involve the ascending aorta (DeBakey I, II; Stanford A). A total of 40% are type III DeBakey, B Stanford and are divided into complicated and uncomplicated. The complicated type B AAD is associated with ruptures, organ malperfusion, and a rapid increase of aortic diameter. Type B complicated dissections need operative treatment.