Diseases of the Aorta

Acute aortic dissection: an update

The aorta, which has a complex intrinsic biology and sophisticated mechanical properties for conducting the blood ejected from the left ventricle to the rest of the systemic arterial bed, is the largest and strongest artery in the body. It carries roughly 200 million liters of blood in an average lifetime. Any process that undermines the architecture threatens the structure, stability, and functionality of the aorta. In this regard, acute aortic dissection (AAD) requires special attention because it is the most catastrophic acute illness of the aorta; it has high morbidity and mortality because of potentially fatal complications. AAD has, therefore, become an important topic of recent research, and knowledge about this disease has improved during the past few years. Up-to-date knowledge about the natural history, epidemiology, presentation, physiopathology, evolution, management, follow-up, and long-term outcomes of AAD are summarized in this review.

Spontaneous regression of an abdominal aortic aneurysm in an immunocompromised patient

Spontaneous aneurysmal regression is a rare event, having been observed only in association with arteritides or immunosuppression following solid-organ transplantation. In particular, the spontaneous regression of an aortic aneurysm, to our knowledge, has never been documented. We report a case of a 46-year-old, HIV-positive, African-American man who developed an asymptomatic juxtarenal abdominal aortic aneurysm, which significantly regressed over a 6-month period in the absence of arteritides or systemic immunosuppressive therapy. This case describes the spontaneous regression of an inflammatory AAA in an HIV-positive patient. Further studies will be required to determine if this was an isolated occurrence or if it occurs with any frequency in specific patient populations.