How is aortic dissection treated? continued...
Initial emergency treatment
Treatment for aortic dissection should be started immediately following the diagnosis. The goal of initial emergency treatment is to relieve pain and to reduce the blood pressure on the dissection (reduction of the pulsatile load). This helps prevent additional bleeding and reduces the risk of a rupture.
Typically, you are put immediately in an intensive care unit (ICU) or taken to the operating room. Your doctor will continuously monitor and control your blood pressure, pulse, and heart activity.
Treating type A dissections
Typically, 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).
In this 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 a man-made 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.
The surgery cannot be done 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 include:
- Kidney (renal) failure.
- Infections in the lung and lung failure.
- 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 needed if:
- Your aorta has ruptured.
- You have pain that cannot be controlled.
- Other arteries or organs are damaged.