Aortic Dissections

Aortic dissection is a life-threatening condition in which a tear develops in the inner layer of the aorta, the major artery carrying blood to the heart. Blood flows through the tear and causes the inner and middle layers to pull apart from each other.

Early detection and immediate treatment greatly improve your chance of survival. Because aortic dissections are so complex, only specialized cardiac and vascular teams such as the experienced surgeons at the MedStar Heart Institute are qualified to successfully manage and treat these cases.

In fact, our experienced cardiac and vascular surgeons repair the most aortic dissections in the mid-Atlantic region.

There are two types of aortic dissections, depending on where the tear begins and ends:

• Type A: This type is more common and more dangerous. In these cases, the tear occurs in the ascending aorta where it exits the heart and extends down through the descending aorta. The tear may extend into the abdomen. Type A cases usually require emergency surgery.
• Type B: This type involves a tear in the descending aorta only, which may also extend into the abdomen. Depending on where the tear develops, our doctors may recommend medication or surgery.

What causes an aortic dissection?

Aortic dissections occur in weakened areas of an artery. Risk factors may include:

• Chronic high blood pressure
• Genetic conditions such as Marfan syndrome
• Chest trauma
• Aortic aneurysm

What are the symptoms of an aortic dissection?

A patient suffering from the tearing of an aortic dissection may show symptoms similar to those of a heart attack. Symptoms include:

• Sudden or severe chest or upper back pain; patients describe it as a tearing or ripping sensation that spreads down the back
• Loss of consciousness or fainting
• Abdominal pain
• Sudden leg pain with reduced blood flow to the area

How will my doctors diagnose an aortic dissection?

When our doctors suspect an aortic dissection, they will immediately need pictures of the heart and aorta. They may order one of the following imaging procedures:

• Echocardiogram
• Computed Tomography (CT scan)
• Magnetic Resonance Imaging (MRI)

Learn more our cardiac imaging services.

How will my doctor treat an aortic dissection?

An aortic dissection is an emergency condition requiring immediate diagnosis and treatment. Surgery and/or medication may be necessary, depending on the location and type of tear:

• Type A: Type A dissections, which involve a tear that starts in the ascending aorta and may extend as far as the abdomen, usually require surgery. During the procedure, our cardiac surgeons remove either a portion of the aorta or the entire torn aorta and replace it with a synthetic tube called a graft.
• Type B: Your doctor will treat Type B aortic dissection with medication. If medication fails, your doctor may recommend intravascular grafting (a form of minimally invasive surgery) or surgery.

Aortic valve repairs

Some patients may need to have their aortic valve replaced if the damaged aorta caused any valve leakage. Only very sophisticated heart and vascular teams, like our experienced surgeons at the MedStar Heart Institute, can perform these procedures at the same time. Take a virtual tour of our hybrid suite.

Learn more about heart valve repairs and replacements.

The MedStar Heart Institute is the only place to go for heart surgery. Schedule an appointment or second opinion with one of our top surgeons or call 202-877-DOCS. Or order a free information kit about our cardiac surgery program.