In this episode of Critical Care Scenarios, Brandon Odo and Brian Bowling interview vascular surgery fellow Travis Hughes about aortic dissections, specifically type B dissections. The discussion covers the differences between type A and type B dissections, the newer zone-based classification system, and the importance of understanding the pre-, intra-, and post-operative aspects of patient care. Travis explains the risks associated with both types of dissections, emphasizing end-organ ischemia in type B dissections, and details his approach to managing a patient presenting with an aortic dissection, including assessing stability, controlling blood pressure and heart rate, and preventing complications. The conversation further explores treatment options, transitioning patients to oral medications, the need for close monitoring and follow-up imaging, and potential long-term complications such as aneurysmal degeneration and stent-related issues.
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