Recent recognition of familial clustering of patients with abdominalaorticaneurysm, the identification of genetic defects in collagen in a family with multiple aneurysms' and the detection of abnormal collagenase and elastase in tissue from aorticaneurysms resected at operation have led some to the assumption that atherosclerosis is invariably the underlying pathophysiologic mechanism.
Dilatation of the aortic knob and descending thoracic aorta is typical of distal disease.
For ascending aortic dissection, the procedure consists in transection of the ascending aorta with use of cardiopulmonary bypass, obliteration of the false lumen by approximation of the inner and outer walls of the false channel, and end-to-end anastomosis of the transected aorta.
