Aortic Dissection Repair

What is an aortic dissection?

An aortic dissection is a tear (dissection) in the wall of the body’s main artery (aorta). The aorta sends blood from your heart to the rest of your body. A tear causes blood to get in between the aorta’s 3 layers. This reduces the amount of oxygen and nutrients that can get to your body’s organs.

Aortic dissection is a medical emergency. Early diagnosis and treatment are important.

Over time, the tear can affect your brain, lungs, arms, legs, and heart. This depends on where along your aorta the tear occurs. Treatment also depends on where the tear is located. You will need surgery if the tear is on the ascending aorta. This is the part of the aorta that goes up through your chest toward your head.

Things that make it more likely to have an aortic dissection include:

• High blood pressure

• Injury from an accident

• Hereditary conditions that are passed down in families

• Structural heart problems

• Smoking

Why might I need an aortic dissection repair?

An aortic dissection can be life-threatening if it's on the ascending aorta. This is the part of the aorta that goes up through your chest toward your head. A surgeon must repair this as soon as possible.

There are 2 possible surgery methods for aortic dissection repair. The first is standard open-heart surgery. The second is less-invasive endovascular surgery. This may be advised if you aren’t strong enough for open-heart surgery. It may also be advised if the dissection is in your descending aorta. This is the part of your aorta that goes down through your chest and belly. But not all hospitals offer this method.

What are the risks of aortic dissection repair?

As with any procedure, problems can occur. Some possible complications may include:

• Stroke

• Heart attack

• Lung infections

• Bleeding

• Kidney failure

• Liver failure

• Paralysis

• Risks from anesthesia

• Death

You may have other risks depending on your health condition. Discuss any concerns with your healthcare provider before the procedure.

How do I get ready for aortic dissection repair?

If you need emergency surgery for an aortic dissection, you won’t be able to get ready in advance.

But if possible, before you are given medicine to put to you to sleep (general anesthesia), tell your healthcare provider:

• If you are allergic to any medicines

• If you have any loose teeth, bridges, crowns, or other types of dental work

• About all the medicines you take. This includes both over-the-counter and prescription medicines. It also includes vitamins, herbs, and other supplements. Some could cause too much bleeding or other problems during surgery.

Your provider may have other instructions for you based on your health condition.

What happens during aortic dissection repair?

Surgery to repair an aortic dissection is very complicated. Your doctor can explain what to expect for your surgery. You will be given general anesthesia to prevent pain and put you to sleep during the procedure.

A healthcare provider will carefully watch your heart rate, blood pressure, and other vital signs during the procedure.

For the endovascular method

• Your surgeon will attach a synthetic graft to the end of a tube (catheter). The graft is made of metal and polyester. Your surgeon will place the catheter into an artery in your leg.

• Using X-ray images as a guide, the surgeon will thread the graft through your artery, to the affected part of the aorta for the repair. X-ray dye (contrast medium) may be used to find the best placement of the graft and its correct position. 

• Your surgeon will remove the catheter. They will close the incision and put a small bandage on the wound.

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What happens after aortic dissection repair?

Next steps

Before you agree to the test or the procedure make sure you know:

• The name of the test or procedure

• The reason you are having the test or procedure

• What results to expect and what they mean

• The risks and benefits of the test or procedure

• What the possible side effects or complications are

• When and where you are to have the test or procedure

• Who will do the test or procedure and what that person’s qualifications are

• What would  happen if you did not have the test or procedure

• Any alternative tests or procedures to think about

• When and how will you get the results

• Who to call after the test or procedure if you have questions or problems

• How much will you have to pay for the test or procedure