Hello and welcome to the Zero to Finals podcast.

My name is Tom and in this episode I'm going to be going through Aortic Dysection.

And you can find written notes on this topic at zero tofinals.com slash aortic dissection

or in the vascular surgery section of the zero-definals surgery book.

So let's get straight into it.

Aortic dissection refers to when a break or a tear forms on the inner layer of the aorta,

allowing blood to flow between the layers of the wall of the aorta.

There are three layers to the wall of the aorta,

the intimer, media and adventitia layer.

With aortic dissection, blood enters between the intemar and the media layers of the aorta.

A false aneurysm full of blood is formed within the wall of the aorta,

between the intimer and media layers. The term intramural refers to within the walls of the

blood vessel. Let's talk about the classification. Aortic dissection most commonly affects the ascending aorta and the aortic arch, but it can affect any part of the aorta.

The right lateral area of the ascending aorta is the most common sight of a tear in the intimer layer, as this is under the most stress from blood

being pumped hard out of the heart. There are two classification systems, the Stanford system

and the Debakey system. With the Stanford system, a type A dissection is when the dissection

affects the ascending aorta before the

brachio-Catholic artery. A type B dissection refers to when the dissection affects the

descending aorta after the left subcalabian artery. With the debakey system, a type 1 dissection is where it begins in the ascending aorta

and involves at least the aortic arch, if not the whole aorta.

A type 2 dissection is when the dissection is isolated to the ascending aorta.

A type 3A dissection refers to when it begins in the descending

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