Aortic Dissection - Topic Overview
Treating type A dissections
Traditionally, the first line of treatment for type A dissections
(dissection of the aorta involving the ascending aorta) is surgery.
The goal of the operation is to prevent death due to bleeding and to
reestablish blood flow into the extremities and inner organs (if branches of
the aorta are involved in the dissection process).
open-heart procedure, your chest is opened and the surgeon removes the part of
the aorta where the tear is found. The portion of the aorta removed can be
replaced with synthetic material, such as a Dacron tube graft. Another approach
uses a similar graft that is placed inside the aorta; in this approach the
ascending aorta is not replaced but internally reinforced.
heart valves are involved in the dissection, they must be repaired to guarantee
a regular blood flow and function of the heart. In some cases the aortic valve
cannot be repaired and has to be replaced. If dissection involves the coronary
arteries, these arteries may have to be disconnected from the original aorta
and sewed back on to reestablish blood flow to the heart (coronary artery
An additional operation is often needed.
The surgery cannot be performed if you are already suffering from a
severe complication in the process of dissection, such as a stroke. In this
situation an operation would lead to severe bleeding in the brain.
Possible complications of aortic dissection and its surgery
- Kidney (renal)
- Infections in the lung and lung
- Decreased heart function and heart attack.
It is sometimes not possible to use surgery in type A
dissections. In this case, the same procedures and medicines outlined in the
initial emergency treatment section are used.
Treating type B dissections
Type B dissections
are usually treated with medicines. In rare cases, a procedure or surgery may be necessary
- Your aorta has ruptured.
- You have
pain or high blood pressure that cannot be controlled.
- You have a
lot of bleeding.
- Other arteries or organs are damaged.