HEMODYNAMIC CONSIDERATIONS REGARDING THE MECHANISM AND PREVENTION OF AORTIC DISSECTION

We describe the hemodynamic principles that we postulate are responsib le for the development of aortic dissection. Two types are differentia ted: the ''hypertensive'' and the ''Marfan'' types. The former is char acterized by moderate aortic dilatation and considerable blood pressur e elevation, the latter by considerable aortic dilatation only. The ro le of wall stress in the development of the intimal tear and the propa gation of the process of dissection are discussed. We recommend that p atients who are at high risk for developing aortic dissection-those wi th Marfan's syndrome and dilated aortas-should undergo aortoplasty and wall reinforcement as a simple, safe, and effective way to prevent ao rtic dissection.