PREVALENCE, CAUSAL FACTORS AND DIAGNOSIS OF ANEURYSM OF THE ASCENDING AORTA

Aortic dissection — is one of the severest complications of aortic aneurysm that leads to high mortality. The article reviews the literature that studies aneurysm of the aorta and its complications in the scope of modern achievements in science. The mechanisms of occurrence of aortic aneurysm and its complications differences in etiology and structural features of aortic aneurysms in patients of all ages. The most common cause of aortic aneurysms in young is a Marfan syndrome. The expansion of the aorta is found in 50% of patients suffering from Marfan syndrome from their childhood. In 1% of patients with aneurysm of the ascending aorta, aortic bicuspid valve exhibit. Reduced mechanical strength of the wall of the aorta is due to lack of fibrillin-1 in the embryonic period. The risk of aortic aneurysm and its rupture increases with the diameter of the aorta. In the wall of the aneurysm accumulated inflammatory cells and increased levels of cytokines, which can help to increase the production of matrix metalloproteinases macrophages and smooth muscle cells. Group of Japanese authors found that the formation of aneurysms of the thoracic aorta is coded by 200 genes that are responsible for inflammation, decay of specific proteins and cell apoptosis aortic wall. The most dangerous complications of aortic aneurysm is its separation and rupture. Aortic dissection — the most common disaster of acute diseases of the aorta. Mortality from rupture of the aorta is 40–90%, noted the relationship with pregnancy — half of all cases of aortic wall stratification in women younger than 40 years occurred during pregnancy hypertension, thinning of the vessel wall and the expansion of the aorta — the most important factors that increase the tension in the wall, leading to aortic dissection or rupture. Stratification of people in older age groups generally occurs against a background of atherosclerosis. Diagnosis of aortic aneurysm, despite the rapid growth of new methods is quite complicated. According to most researchers, the correct diagnosis is established only in 50% of cases. The diagnosis of aortic dissection is determined more rarely — only a third of modern methods of examination: computer and magnetic resonance imaging, transthoracic and transesophageal echocardiography, angiography. A number of authors asked to determine blood smooth muscle myosin aortic wall (D-dimer). According to studies, it was concluded that the level of this marker less than 500 ng/ml exclude acute bundle within the first 24 hours of onset.