Critical Matters Acute Type B Aortic Dissection
Dec 25, 2025
Dr. Firas Mussa, a vascular surgeon and professor at McGovern Medical School, dives deep into the complex world of acute type B aortic dissection. He emphasizes the critical role of intensivists in managing these urgent cases and unpacks the differences between dissection types. Mussa discusses risk factors like hypertension, outlines diagnostic standards, and explores treatment options, including TEVAR. He also highlights the importance of ICU protocols in improving patient outcomes and factors influencing clinical trials. Personal reflections and book recommendations add a nice touch!
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Intensivists Are Central To Aortic Care
- Aortic dissection care is inherently multidisciplinary and intensivists are central to outcomes.
- Intensivists manage half of type B cases and guide blood pressure, heart rate, and medical therapy.
Different Acute Aortic Syndromes Aren't The Same
- Acute aortic syndromes include dissection, intramural hematoma, and penetrating aortic ulcer but they differ pathologically.
- Intramural hematoma can heal or convert to dissection, while penetrating ulcers are atherosclerotic and managed by size and symptoms.
Hypertension Drives Most Dissections
- Incidence of aortic dissection is roughly 2–4 per 100,000 with thousands of US cases yearly.
- Uncontrolled hypertension causes about 90% of dissections; connective tissue disorders and stimulants (cocaine, meth) are other key risks.