Aortic Aneurysm and Dissection: Risk Factors and Pathophysiology

Abstract Ascending aortic dissection, frequently a catastrophic sequalae of aortic aneurysm, is an often-fatal cardiac surgical emergency that arises from a tear in the intimal layer of the aorta thereby permitting blood to propagate along the aortic wall. Despite advances in surgical management, morbidity and mortality remain exceedingly high, underscoring the need to better understand risk factors and pathophysiological mechanisms. This review discusses current evidence on contributors to ascending aortic aneurysm and dissection. Improved characterization of risk profiles and mechanistic pathways may refine screening strategies, inform timing of prophylactic surgical intervention, and guide development of targeted medical therapies.