Consequences of dissection

The acute sequelae of dissection include aortic rupture (usually into the pericardium or pleura), disruption of the aortic valve apparatus leading to acute aortic regurgitation and left ventricular failure, and extension of the dissection into the branch walls of arteries originating from the aorta, leading to distal ischemia or infarction. This is more common in large arteries such as the innominate, subclavian, carotid, or renal arteries, but any artery may be affected. Involvement of intercostal arteries in descending aortic dissections may prejudice blood flow to the anterior spinal artery. Distal extension of type IIIb dissection involves the left iliac artery more commonly than the right. Involvement of branch arteries may lead to ischemia or infarction of the territory supplied.

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