Acute aortic syndrome - When is operative treatment indicated?

Four different aortic diseases are summarized under the term acute aortic syndrome. Aortic dissection, contained aortic rupture, intramural aortic hematoma, and penetrating aortic ulcer. Therapeutic decision making depends on both the localization within the aorta and the presence of a complicated course. If the ascending aorta is involved surgical therapy has to be considered. In the presence of a complicated course of a disease of the descending aorta interventional or surgical therapy may be indicated. An interdisciplinary approach between Internal Medicine, Surgery, interventional Radiology, and anesthesiology is helpful.