Aortic dissection, also known as aortic dissection aneurysm, is a serious cardiovascular disease caused by various reasons leading to tearing and separation of the intima and media of the aorta, blood flow, and pathological changes in the true and false lumens of the artery. The clinical characteristics of aortic dissection are acute onset, sudden severe pain, hypertension, cardiac manifestations, and other organ or limb ischemia symptoms. Its prognosis is related to the location, scope, and degree of the lesion. The more distal, the smaller the scope, and the less bleeding, the better the prognosis; If not rescued in a timely manner, death can occur within 48 hours due to aortic dissection, rupture to the chest, abdominal cavity, or pericardial cavity, progressive mediastinal and retroperitoneal bleeding, as well as acute heart failure or renal failure, with a mortality rate of up to 50%. Below, the editor will introduce the postoperative precautions for everyone.
1、 Surgical plan for aortic dissection
1. Type A aortic dissection: Based on preoperative diagnosis, different surgical methods are used, mainly including treatment of the aortic root, total arch replacement, and distal elephant trunk. The surgical methods for treating the aortic root include simple ascending aortic replacement, aortic root replacement, valve preserving aortic root replacement, and aortic catheterization after aortic root sinus reconstruction, based on the preoperative cardiac and vascular lesions.
2. Type B aortic dissection: If the patient is not suitable for interventional treatment and is young, standard type B dissection surgery, namely total thoracic and abdominal aortic replacement, is required. It is recommended that patients undergo reasonable surgery under the guidance of professional doctors.
2、 Postoperative precautions for aortic dissection
Generally, postoperative precautions for patients with aortic dissection mainly include psychological adjustment, lifestyle adjustment, regular follow-up, etc. The specific contents are as follows:
1. Psychological adjustment: Due to the long recovery period after surgery, it is usually necessary to maintain a good mentality, actively cooperate with treatment, and timely understand the patient's needs to relieve their tension and anxiety, such as listening to music, chatting, and other good ways to relieve stress.
2. Lifestyle regulation: Developing a good lifestyle and habits is the first step to achieving the best long-term results. Eat a low salt and low-fat diet, quit smoking and drinking, and maintain a good mentality. Engage in appropriate activities and gradually increase, control weight, and lower blood lipids, blood pressure, and blood sugar levels. At the same time, patients should maintain a light diet and eat more high protein foods such as lean meat, soybeans, and milk to promote physical recovery. They can also eat more fresh fruits and vegetables appropriately to maintain a balanced nutrition and avoid spicy and stimulating foods to prevent wound infections.
3. Oral medication: drugs that slow down heart rate, such as betaloc and bisoprolol, should be used. During rest, the heart rate should be controlled at 60-80 beats per minute. If it is too fast or too slow, timely medical attention should be sought. Patients who develop atrial fibrillation after surgery and take amiodarone should gradually reduce their dosage and stop using it, and regularly check their liver function and chest X-ray; Lipid regulation: For patients with obesity or abnormal blood lipids, medication should be taken based on examination results under dietary control; Lowering blood pressure: Hypertensive patients must have a low salt and low-fat diet, a regular lifestyle, sufficient rest, regular medication, regular monitoring of blood pressure, and control blood pressure at 140/90mmHg. Postoperative follow-up and examination: Patients with arterial dissection should also regularly visit the vascular surgery department of the hospital for follow-up after surgery to keep track of their recovery. Generally, it is recommended to have a follow-up examination every three months, another examination every six months, and then an annual follow-up thereafter. If sudden chest pain or tightness occurs, one should promptly seek medical attention at the nearest hospital and undergo a full course CTA of the aorta to clarify the condition.
It should be noted that even if the postoperative recovery is good, the surgical site is still relatively fragile, so patients should be more vigilant and pay attention to their physical condition at all times.
Rapid progress, high misdiagnosis rate and mortality rate, making it a serious emergency in clinical practice. Everyone should have a full understanding of the characteristics of this disease, strictly follow the doctor's advice to take medication, and seek medical attention promptly if there is any discomfort.