Aortic dissection repair (2023)

What is an aortic dissection?

An aortic dissection is a tear (dissection) in the wall of the body's main artery, the aorta. The aorta sends blood from the heart to the rest of the body. The rupture causes blood to enter the 3 layers of the aorta. This reduces the amount of oxygen and nutrients available to the body's organs.

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

Over time, a tear can affect the brain, lungs, arms, legs, and heart. It depends on where along the aorta there is a tear. Treatment also depends on where the tear is located. You will likely need surgery if the tear is in the ascending aorta. This is the part of the aorta that ascends through the chest and towards the head.

Risk factors for aortic dissection include:

  • High pressure
  • accidental injury
  • Genetic conditions passed down in families
  • Structural problems of the heart
  • Burn

Why might I need an aortic dissection repair?

Aortic dissection can be fatal if located in the ascending aorta. This is the part of the aorta that ascends through the chest and towards the head. The surgeon needs to fix it ASAP.

There are 2 possible surgical methods to repair an aortic dissection. The first is standard open-heart surgery. The second is less invasive endovascular surgery. This may be recommended if you are not strong enough for open heart surgery. It may also be indicated if the dissection is in the descending aorta. This is the part of the aorta that runs down through the chest and abdomen. But not all hospitals offer this method.

(Video) Acute Type A Aortic Dissection Repair

What are the risks of aortic dissection repair?

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

  • AVC
  • Myocardial infarction
  • lung infections
  • bleeding
  • risk of anesthesia
  • Death

You may have different risks depending on your specific health condition. Be sure to discuss any concerns with your doctor before the procedure.

How to prepare for aortic dissection repair?

If you need urgent aortic dissection surgery, you can't prepare in advance.

But if possible, before you get a sleeping pill (general anesthesia), tell your doctor:

  • If you are allergic to any medications
  • If you have loose teeth, bridges, crowns or other types of dental work
  • About all the medications you take. This includes over-the-counter and prescription drugs. It also contains vitamins, herbs and other supplements. Some can cause a lot of bleeding or other problems during surgery.

Your provider may have different instructions for you depending on your medical condition.

What Happens During Aortic Dissection Repair?

Surgery to repair an aortic dissection is very complex. Your doctor can explain what to expect after surgery. Here's an example of how it's done:

(Video) Miles Rosen Aortic Dissection Surgery

You will be given general anesthesia to prevent pain and put you to sleep during the procedure.

During the procedure, your healthcare professional will closely monitor your vital signs, such as your heart rate and blood pressure.

For traditional open-heart surgery

  • The surgeon will make an incision in your chest or abdomen. The exact location will depend on where the section is located.
  • The heart bypass machine will take over pumping the blood around your heart and lungs.
  • Once the surgeon finds a rupture, artificial (synthetic) grafts can replace the damaged parts of the aorta. If the aortic valve is damaged, the surgeon may also insert a replacement valve.
  • When the surgeon has made all the repairs, he will remove the cardiac bypass device and close the incision.

For the intravascular method

  • Your surgeon will attach a synthetic graft to the end of the tube (catheter). The graft is made of metal and polyester. Your surgeon will place a catheter in an artery in your leg.
  • Using X-rays as a guide, the surgeon will guide the graft through the artery to the affected part of the aorta for repair. X-ray dye (contrast agent) can be used to find the best graft placement and its correct position.
  • The surgeon will remove the catheter. He will close the incision and put a small bandage over the wound.

What happens after an aortic dissection is repaired?

No hospital

You may need at least 1 month to recover from surgery.

You will be in the hospital for about the first week. You will usually be in the intensive care unit (ICU) until your vital signs stabilize. You will be moved to the usual nursing floor to continue your recovery before returning home. You may need medication for nausea, pain and discomfort while you are in the hospital.

Plan for someone to drive you home. It may not be safe to start driving right away. Ask your supplier when you will be able to drive again.

(Video) Aortic Aneurysm and Aortic Dissection

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You may have had open heart surgery, it may take several months to fully regain your energy while your body heals. Make sure you get enough rest and consume enough calories and nutrients to improve your energy.

You will probably need to take blood pressure medication. High blood pressure puts pressure on the incision wall and the heart.

If your surgery involved a valve replacement, your doctor may also give you a blood thinner to reduce your risk of blood clots.

The recovery time after endovascular surgery is usually shorter. But there may be problems. These may include blood leakage from the graft. You may need to contact your supplier every 6 months.

After your aortic dissection is repaired, you'll need to be careful with strenuous exercise and sports. These activities can put pressure on the aortic wall. This can increase the risk of another aortic injury. Light to moderate exercise is generally fine. Ask your doctor what activities are safe for you.

If you smoke, quit smoking as soon as possible. This gives you the best chance of successfully recovering from surgery and improving your overall health.

(Video) Open Aortic Aneurysm Repair

Ask your doctor what types of foods to eat and what types of foods to avoid. The recommended diet will depend on all your health needs.

Continue taking your medications as directed.

A follow-up visit will be scheduled to see how you are healing and recovering from the procedure.

While healing, be sure to watch your incision for any problems. Call your provider if:

  • Your incision becomes more painful, red, or swollen.
  • There is drainage from the incision
  • You have a fever of 100.4°F (38°C) or higher

Next steps

Before agreeing to an examination or procedure, make sure you know:

  • The name of the test or procedure
  • The reason you are having the test or treatment
  • What results to expect and what they mean
  • The risks and benefits of the test or procedure
  • What are the possible side effects or complications
  • When and where you should have a test or procedure
  • Who will perform the examination or procedure and what are their qualifications
  • What would happen if you didn't have a test or procedure
  • Any alternative tests or procedures should be considered
  • When and how will you get your results
  • Who to call after the test or procedure if you have questions or problems
  • How much will you have to pay for the examination or treatment


What is aortic dissection repair? ›

Open-heart surgery to repair an aortic dissection involves making a 7- to 10-inch incision over the middle of the sternum, or breastbone, then dividing the sternum to allow access to the heart. In some cases a less invasive option, involving a slightly smaller sternal incision, is possible.

What is the survival rate of aorta dissection surgery? ›

"Hospital mortality at a high-volume center like U-M, where aortic dissection patients are taken care only by highly experienced aortic surgeons, can be as low as 5%, while the same patient operated on at a low-volume center may be 20% or higher," Eagle said.

What is the life expectancy after successful repair of aortic dissection? ›

Although specific information about overall life expectancy after aortic dissection repair is not available, a recent study from the International Registry of Acute Aortic Dissection reported that about 85% of patients who have undergone successful repair of acute dissection involving the ascending aorta remain alive ...

When should aortic dissection be repaired? ›

You will most likely 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. Risk factors for aortic dissection include: High blood pressure.

Can you live a normal life after aortic dissection surgery? ›

Returning to Daily Life

Post-dissection, many patients wonder when it is appropriate to return to their previous lifestyle. With excellent blood pressure control and conscious limits to physical activity, you can continue to live a long, full life after a dissection.

What is the #1 cause of aortic dissection? ›

Aortic dissection most often happens because of a tear or damage to the inner wall of the aorta. This very often occurs in the chest (thoracic) part of the artery, but it may also occur in the abdominal aorta. When a tear occurs, it creates 2 channels: One in which blood continues to travel.

How serious is aortic dissection surgery? ›

Type A aortic dissections that are located in the ascending aorta that exits the heart typically require emergency open heart surgery. This is because the dissection can split open, or “unzip,” the aorta. This can cause bleeding into the pericardium, the sac-like membrane that envelops the heart, or into the abdomen.

How painful is aortic dissection? ›

Pain: You may experience sudden severe pain in the chest, back or abdomen. A radiating pain in the chest or upper back is described as a tearing or ripping sensation. The pain can extend to the legs and make walking difficult. Difficulty breathing: You may feel short of breath or lose consciousness.

Is aortic dissection curable? ›

Acute aortic dissection can be treated surgically or medically. In surgical treatment, the area of the aorta with the intimal tear is usually resected and replaced with a Dacron graft. Emergency surgical correction is the preferred treatment for Stanford type A (DeBakey type I and II) ascending aortic dissection.

What is the average age of aortic dissection patients? ›

The median age was 52.0 years old in whole cohort. The multiple comorbidities were more common in old age groups (60 s, 70 s, 80 s), while the 20 s group patients had the highest proportion of Marfan syndrome (28.1%). Preoperative hypotension was highest in 80 s (16.7%, P = 0.038).

How long does an aortic repair take? ›

Surgery for aortic aneurysm replacement may take 2 to 4 hours. Most people recover in the intensive care unit (ICU) after the surgery.

How is life after aorta repair? ›

You will feel more tired than usual for several weeks after surgery. You may be able to do many of your usual activities after 4 to 6 weeks. But you will probably need 2 to 3 months to fully recover. Some people find that they feel sad or more emotional than usual while they are recovering after this surgery.

Are there warning signs before aortic dissection? ›

Aortic Dissection Symptoms

Symptoms usually begin suddenly and may include severe chest or back pain that may be felt as sharp or stabbing or as a tearing. Sometimes, the pain moves to the neck, jaw, shoulder, arm, or abdomen. Acute aortic dissection can be life-threatening and requires immediate treatment.

Is aortic dissection open heart surgery? ›

Untreated, an aortic dissection can lead to death. A dissection that involves the ascending aorta almost always requires emergency open-heart surgery to repair the vessel and prevent death.

What can you not do with an aortic dissection? ›

Aortic dissection patients should avoid any strenuous activities that can cause dangerous increases in blood pressure. Although little is known about exercise in dissection patients, heavy weightlifting should generally be avoided.

Can aortic dissection happen again? ›

Acute aortic dissection (AD) is a potentially catastrophic disease process, which has undergone significant improvement in treatment options leading to increased overall survival; however recurrent aortic dissection (RAD) is a rare phenomenon that may require a multidisciplinary approach and more complex treatment ...

Can you fly after an aortic dissection? ›

In direct answer to your question about travel, there is nothing about a long airplane ride that would put additional stress on the aorta and increase risk of worsening the dissection, as long as the patient does not do heavy lifting.

What is a common complication of aortic dissection? ›

Possible complications of aortic dissection include: Death due to severe internal bleeding. Organ damage, such as kidney failure or life-threatening intestinal damage. Stroke.

What are the red flags of aortic dissection? ›

Sudden, severe upper back or chest pain (often described as a “tearing” sensation from the neck down the back) Sudden, severe belly pain. Leg pain. Mild neck, jaw, or chest pain.

Can stress cause aortic dissection? ›

“The aorta degenerates over time and becomes more dilated, which increases stress on the aortic wall,” Elefteriades said. “Severe physical or emotional stress increases blood pressure to the point where the tensile limit of the aortic tissue is overwhelmed, causing the rupture.”

Who is at risk for aortic dissection? ›

Pre-existing aortic aneurysm. Atherosclerosis. Pregnancy and delivery (risk compounded in pregnant women with connective tissue disorders such as Marfan syndrome) Family history.

Is aortic dissection rare? ›

Aortic dissection is rare, affecting about 30 in 1 million people each year. But knowing the symptoms and risk factors — a genetic predisposition in particular — can be lifesaving. There are two types of aortic dissection.

Does aortic dissection run in families? ›

About 20 percent of people with thoracic aortic aneurysm and dissection have a genetic predisposition to it, meaning it runs in the family.

How long can aortic dissection go untreated? ›

Acute aortic dissection (AoD) is rare, particularly in those younger than 40 years of age, but early and accurate diagnosis is crucial, as the mortality rate increases by approximately 1% per hour over the first 48 hours and can reach 70% at 1 week if left untreated.

Can an aortic dissection lead to heart failure? ›

Rupture of aortic dissection into the right atrium, right ventricle, or main pulmonary artery may lead to a left to right shunt and congestive heart failure6.

Can you live a normal life after aortic aneurysm repair? ›

Although aneurysms contribute to more than 25,000 deaths in the United States each year, it's actually possible to live with and successfully treat an aortic aneurysm.

What is the lifespan of an aortic graft? ›

The decision to repair versus replace the aortic valve is based on complex factors, as well as the experience and results of the particular treatment center. At the Aortic Program, a repaired valve is expected to have a life of ten years or more (comparable to the minimum expectation for a bioprosthesis).

What is the success rate of aortic valve repair? ›

In the NIHR study, bioprosthetic valves appeared safe, and they were linked to average lifespans when matched to the population having surgery. Ten years after replacement, the great majority of people (94%) had a functioning valve. After 20 years, more valves had failed, with 48% of valves deteriorating.

What are the complications of aortic repair surgery? ›

Some possible complications may include, but are not limited to, the following:
  • Damage to surrounding blood vessels, organs, or other structures by instruments.
  • Kidney damage.
  • Limb ischemia (loss of blood flow to leg/feet) from clots.
  • Groin wound infection.
  • Groin hematoma (large blood-filled bruise)
  • Bleeding.

What is the first test for aortic dissection? ›

Computerized tomography (CT) scan of the chest.

X-ray are used to produce cross-sectional images of the body. A CT of the chest can confirm a diagnosis of aortic dissection.

What is the average time to diagnosis for aortic dissection? ›

We know from the International Registry of Acute Aortic Dissection (IRAD) (2) that the median time from presentation to diagnosis for all acute aortic dissection patients is over 4.3 hours.

Should you exercise with aortic dissection? ›

recommended mild to moderate intensity aerobic exercise (3–5 metabolic equivalents) in patients with aortic dissection for at least 30 min on most days of the week, for a total of 150 min/week, if the goal is a reduction in resting blood pressure and improved cardiovascular health, while possibly minimizing the risk of ...

What is aortic dissection? ›

An aortic dissection is a serious condition in which a tear occurs in the inner layer of the body's main artery (aorta). Blood rushes through the tear, causing the inner and middle layers of the aorta to split (dissect). If the blood goes through the outside aortic wall, aortic dissection is often deadly.

Has anyone survived an aortic dissection? ›

For people who experience aortic dissection, simply surviving the event is a triumph. Nearly 18% of those who sustain aortic dissection die before arriving at the hospital, and 21% die within 24 hours if they don't have surgery.

Is aortic dissection medical or surgical? ›

Acute aortic dissection can be treated surgically or medically. In surgical treatment, the area of the aorta with the intimal tear is usually resected and replaced with a Dacron graft. Emergency surgical correction is the preferred treatment for Stanford type A (DeBakey type I and II) ascending aortic dissection.

What is aortic repair surgery called? ›

Open surgery and endovascular repair are the two main types of surgery to repair an aneurysm. During open surgery, a surgeon makes a large cut in your belly or chest. The surgeon then replaces the damaged part of the aorta with a graft. Endovascular repair uses a much smaller incision than open surgery.

Are there warning signs of aortic dissection? ›

Aortic Dissection Symptoms

Symptoms usually begin suddenly and may include severe chest or back pain that may be felt as sharp or stabbing or as a tearing. Sometimes, the pain moves to the neck, jaw, shoulder, arm, or abdomen. Acute aortic dissection can be life-threatening and requires immediate treatment.

What is the most common symptom of aortic dissection? ›

What are the signs and symptoms of aortic dissection?
  • Sudden severe, sharp pain in your chest or upper back; also described as a tearing, stabbing or ripping feeling.
  • Shortness of breath.
  • Fainting or dizziness.
  • Low blood pressure; high suspicion when there's a 20 mmHg pressure difference between arms.
Jul 26, 2021

Does aortic dissection have warning signs? ›

When an aortic dissection occurs, you may experience symptoms similar to those of a heart attack: Pain: You may experience sudden severe pain in the chest, back or abdomen. A radiating pain in the chest or upper back is described as a tearing or ripping sensation.

How long are you in hospital after aortic dissection? ›

You can expect to remain in the hospital for two to three days after surgery. Because your aorta and heart need rest in order to heal, your doctor may recommend that you refrain from driving and lifting anything heavier than 10 pounds for 10 days after surgery.

Is aortic dissection hereditary? ›

About 20 percent of people with thoracic aortic aneurysm and dissection have a genetic predisposition to it, meaning it runs in the family. This type is known as familial thoracic aneurysm and dissection. Many people don't know they have a genetic predisposition to thoracic aortic aneurysm and dissection.

Who gets aortic dissection? ›

We find that patients with poorly controlled blood pressure are at most risk for aortic dissection. Additionally, those with pre-exciting connective tissue diseases, such as Marfan's syndrome, Ehlers-Danlos syndrome and other collagen vascular disorders, are also at high risk for aortic tears.

Is aortic dissection same as a tear? ›

Aortic dissection is when the weakened wall of the aorta tears, causing blood to leak between the layers that make up the walls of your arteries.

Can an aortic dissection heal itself? ›

Treatment. Because aortic dissection is a life-threatening condition, treatment is typically needed immediately. Treatment usually involves surgery; however, in some cases, if the tear occurs in the area of the aorta that is descending into the abdomen, medication may be used to treat the condition.

Can you live 20 years after aortic valve replacement? ›

Pooled data from 85 studies estimated that 89.7% of people survived for two years after surgery, 78.4% at five years, 57.0% at 10 years, 39.7% at 15 years, and 24.7% at 20 years. Subgroup analysis showed that five-year survival declined with increasing patient age (from 83.7% in under-65s to 52.5% for those over 85).

Is aorta surgery considered heart surgery? ›

An aortic valve replacement is a type of open heart surgery used to treat problems with the heart's aortic valve. The aortic valve controls the flow of blood out from the heart to the rest of the body.

How long does an aortic graft last? ›

In conclusion, the Gelseal™ graft used in the ascending aorta demonstrates a small but continuous increase in the diameter, up to 5 years after implantation, without any adverse events.


1. Life after aortic dissection - Medical Minute
(Avera Health)
2. Aortic Dissection Explained
(Cleveland Clinic)
3. Aortic Dissection | Rodney's Story
(Johns Hopkins Medicine)
4. Thoracic Aorta Stent Grafts
(Cleveland Clinic)
5. Repairing a torn aorta—Ben's story—Nebraska Medicine
(Nebraska Medicine Nebraska Medical Center)
6. Image Predictors of Treatment Outcome after Thoracic Aortic Dissection Repair


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