My mom 83 dissection aneurysm, the doctor said that the operation was not good

Hello, aortic dissection aneurysm, it is recommended to do a contrast-enhanced CT examination as soon as possible. The detailed ** method of aortic dissection is as follows:

If the disease is suspected or diagnosed, it should be hospitalized for monitoring**. **The aim is to reduce myocardial contractility, slow down left ventricular contractility (DV DT), and peripheral arterial pressure. **The goal is to keep systolic blood pressure at a heart rate of 60 to 75 beats per minute.

This effectively stabilizes or aborts the further separation of aortic dissection, relieving symptoms and eliminating pain. It is divided into two stages: emergency and consolidation.

a) Emergency** Pain relief: with morphine and sedatives. Replenishment of blood volume:

Bleeding into the pericardium: transfusion in patients with ruptured chest or aorta. Buck:

For patients with hypertension, propranolol 5mg intravenous intermittent administration and sodium nitroprusside intravenous infusion for 25 to 50 g min can be used to adjust the drip rate and reduce blood pressure to the clinical ** index. Significant reduction or disappearance of pain after a drop in blood pressure is a clinical indication for dissection dissection to stop expanding. Other drugs such as verapamil, nifedipine, captopril, and prazosin are options.

Reserpine is also effective as intramuscularly every 4 to 6 hours. In addition, labetalol can be used, which has a dual blocking effect and can be given intravenously or orally. The issues to be aware of are:

In hypertensive patients with large branch obstruction of the aorta, antihypertensive blood pressure should not be used because antihypertensive can aggravate ischemia**. Antihypertensive drugs are not used in patients with low blood pressure, but propranolol can be used to reduce myocardial contractility.

2) Consolidation** Surgery should be performed on patients with proximal aortic dissection, ruptured or near-ruptured aortic dissection, and aortic regurgitation**. For slowly developing and distal aortic dissection, internal medicine can be continued**. Maintain systolic blood pressure, if the above drugs are not satisfied, captopril 25 50 mg can be added 3 times a day, orally.

c) Surgery**.

Stanford Type A (equivalent to Debakey Types I and II) requires surgery**. Debakey type I surgery is ascending aorta + aortic arch artificial vascular replacement + modified stent elephant trunk surgery. Debakey type II surgery is a ascending aortic prosthetic vascular replacement.

If there is aortic regurgitation or coronary artery involvement, aortic valve replacement and bentall are indicated'Surgery.

iv) Intervention**.

Percutaneous stent grafting and, if necessary, surgical procedure is the preferred procedure for Stanford type B (equivalent to Debakey type III).

In this case, it is recommended that it is best to have an interventional procedure** for better results.

This requires specific inquiries to a specialized hospital or specialist.

Hello, in this case, I suggest that hospitalization is needed to further clarify how many ruptures there are and the exact location of the ruptures, so as to further develop a specific intervention plan.

He Chunshui, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine.