Akutes Aortensyndrom

Zusammenfassung

Das akute Aortensyndrom umfasst mehrere akute Erkrankungen der Aorta: Die Aortendissektion, die gedeckte Aortenruptur, das intramurale Hämatom (IMH) der Aorta, und das penetrierende Aortenulkus (PAU). Das gemeinsame Leitsymptom ist der akute Thoraxschmerz. Die Therapieentscheidung erfolgt einerseits nach Lokalisation und andererseits nach Vorliegen einer komplizierten oder unkomplizierten Erkrankung. Generell sind Patienten mit akutem Aortensyndrom, welches die Aorta ascendens (mit-)betrifft, unmittelbar für eine chirurgische Therapie zu evaluieren. Ein unkompliziertes Aortensyndrom ohne Beteiligung der Aorta ascendens wird initial engmaschig überwacht und konservativ therapiert. Bei Auftreten eines komplizierten Verlaufs wird interventionell oder operativ therapiert. Ein interdisziplinäres Therapiekonzept gemeinsam mit Herzchirurgie, Gefäßchirurgie, interventioneller Radiologie, Innerer Medizin und Anästhesie ist sinnvoll.

Abstract

Four different aortic diseases are summarized under the term “acute aortic syndrome”. Aortic dissection, contained aortic rupture, intramural aortic hematoma, and penetrating aortic ulcer. Therapeutic decision making depends on both the localization within the aorta and the presence of a complicated course. If the ascending aorta is involved surgical therapy has to be considered. In the presence of a complicated course of a disease of the descending aorta interventional or surgical therapy may be indicated. An interdisciplinary approach between Internal Medicine, Surgery, interventional Radiology, and anesthesiology is helpful.

Schlüsselwörter

akutes Aortensyndrom - Aorta - Aortendissektion - intramurales Hämatom - penetrierendes Aortenulkus

Keywords

acute aortic syndrome - aorta - aortic dissection - intramural hematoma - penetrating aortic ulceration

• Literatur

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