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Treatment for a thoracic aortic dissection


Once diagnosed, an aortic dissection should be treated quickly. The two main complications are rupture, when the aorta bursts and causes serious internal bleeding, or malperfusion, reduced blood flow to important organs like the kidneys and gut. Both need
quick treatment.

Medical management

All patients with an aortic dissection will receive medications that help control heart rate and blood pressure.

Open surgical repair

Surgery can be performed to repair the section of the aorta that is dissected. To reach the dissection, a physician makes a cut through the breastbone or the side of the chest and repairs the aorta by replacing the dissected section with a flexible fabric tube, called a graft. The graft is sewn into place and acts as a replacement blood vessel. While placing the graft, the doctor stops blood from flowing through the aorta.

Endovascular repair

Endovascular repair is an alternative to open surgical repair. Instead of making a large cut in the chest, the doctor makes a small cut near the hip to access the femoral arteries, a large blood vessel in your thigh. Through these small cuts, an endovascular graft is inserted into the femoral artery through a delivery catheter, which allows it to travel to the aorta. Once it has been positioned in the aorta, the graft seals off the area where the tear begins and makes a new path for the blood to flow through. Below the endovascular graft, an endovascular stent— a self-expanding metal stent that is not covered in fabric— may be placed to gently reinforce the aorta and support the layers of the aortic wall. The graft and stent remain inside the aorta permanently.

Important note: Open surgical repair and endovascular repair are not options for every patient. Both types of repair have pros and cons. The best repair will depend on your condition and needs. Talk about the pros and cons with your doctor.

Remember, every patient is different, and your doctor knows you best. After reading the information on this site, make an appointment to talk to your doctor to help you make the right decision about any treatments or procedures.