An aortic dissection often requires immediate treatment. Without it, the condition can be fatal. In some cases, like an uncomplicated Type B aortic dissection that does not compromise the blood flow to any organ system, it may be treated with observation and/or medications. However, treatment may require surgery, and in some cases immediately. Of those who receive treatment in time, 60 percent are alive 10 years later.
Watchful Waiting and Medical Therapy
Monitoring and Blood Pressure Control
A Type B dissection, which involves a tear in the descending aorta only, may be treated with monitoring and blood pressure control and repeat imaging studies every three months for the first year and yearly thereafter.
You may be put on medications, such as beta-blockers, to lower your heart rate and blood pressure, relieving the force of blood on the aortic wall. If you have an uncomplicated Type B dissection, this may be all you need.
Open Surgical Repair
If you have a Type A dissection, surgery is recommended.
Traditional Open Surgery
In traditional open surgery, the chest is opened and the aorta is repaired. Removal and repair of a dissected aorta usually takes three to six hours, and the hospital stay is anywhere from four to 10 days ore more if complications ensue.
During this major operation, your surgeon will:
- Remove as much of the dissected aorta as he or she can.
- Block the entrance of blood into the aortic wall.
- Rebuild the aorta using a graft made of dacron or woven polyester.
In some cases, an aortic dissection can be repaired through what is known as an endovascular stent-graft.
In this procedure, your surgeon can repair the problem in a minimally-invasive fashion, inserting the graft and stent through tubes or catheters inserted into the blood vessels in the groin. This procedure takes two to four hours, and the hospital stay is usually one to three days.