Q: How do they fix an Aortic Dissection?

Aortic dissection surgery is very complex . For a traditional open-heart surgery, a small incision is made in the chest or abdomen. The exact spot varies depending on the location of the dissection. After the incision, the blood-pumping function of the heart and lungs is replaced by a heart bypass machine. During the surgery, once the tear is found, artificial (synthetic) grafts replace the damaged parts of the aorta. If the aortic valve is damaged, the surgeon may also insert a replacement valve. After the process is completed, the heart bypass machine is removed, and the incision is closed. For the endovascular method, the surgeon attaches a synthetic graft to the end of a tube (catheter). Using X-ray images as a guide, the graft is threaded through the artery to the affected part of the aorta.

Question 1

How common is Aortic Dissection?

Accepted Answer

Aortic Dissection affects 2 in every 10,000 people and can occur at any age.

Question 2

I have heard that Aortic Dissection can be fatal. Is this true?

Accepted Answer

Yes, it is true. However, if Aortic Dissection is detected on time and treatment starts immediately, chances of survival improve drastically. The prognosis depends on how quickly you are diagnosed and treated.

Question 3

When should I call my doctor?

Accepted Answer

You should contact your doctor the moment you observe the symptoms of Aortic Dissection. If you observe chest pain that has developed suddenly, contact a doctor immediately. If you can, go to the emergency room immediately to ensure prompt diagnosis and treatment.

Question 4

I have a genetic condition that can increase my chances of Aortic Dissection. Is there a way to prevent Aortic Dissection in my case?

Accepted Answer

Yes, there is. While some genetic conditions can increase your risk, some types of medications can help prevent Aortic Dissection. Discuss the problem with your doctor to get the right type of prescription medication.

Question 5

Are there any risks of Aortic Dissection surgery?

Accepted Answer

There are some risks associated with the surgery, such as heart attack, bleeding, lung infections, risks due to anaesthesia and stroke. Death can also occur in some cases. But the risks of surgery differ from person to person. After the surgery, ensure that the incision is checked regularly. If it swells up or you notice the incision is leaking, call the doctor immediately.

Question 6

Are there any precautions that I need to take after surgery?

Accepted Answer

You need to ask your doctor about the activities and exercises that can be performed. If exercise is allowed, ask about the intensity. Usually, you will be advised to not participate in any strenuous exercise because it can affect the aortic wall by putting pressure on it. Mild exercise is generally recommended but you should double-check with the doctor.

Question 7

What is the main cause of Aortic Dissection?

Accepted Answer

Aortic Dissection is the result of a weakened area of the aortic wall. One of the common causes of this condition is chronic high blood pressure, which puts stress on the aortic tissue and makes it more susceptible to tearing.

Another rare cause of Aortic Dissection can be congenital conditions. Some people are born with a weakened and enlarged aorta. Conditions like Marfan syndrome or bicuspid aortic valve are also associated with the weakening of the walls of the blood vessels. Aortic Dissection can also be caused by traumatic injury to the chest area.

Certain genetic diseases have also been linked to Aortic Dissection, including:

Turner’s syndrome

Marfan syndrome

Connective tissue disorders, such as Ehlers-Danlos syndrome and Loeys-Dietz syndrome

Inflammatory conditions, such as giant cell arteritis and syphilis.

Question 8

What is the survival rate of an Aortic Dissection?

Accepted Answer

Proper diagnosis and treatment are the keys to recovery. Around 1 in 5 patients with Aortic Dissection die before reaching the hospital. Without treatment, the mortality rate is 1% to 3% per hour during the first 24 hours, 30% during the first week, 80% at 2 weeks, and 90% at 1 year. For treated patients, the hospital mortality rate is about 30% for proximal dissection and 10% for distal.

Question 9

How do they fix an Aortic Dissection?

Accepted Answer

Aortic dissection surgery is very complex. For a traditional open-heart surgery, a small incision is made in the chest or abdomen. The exact spot varies depending on the location of the dissection. After the incision, the blood-pumping function of the heart and lungs is replaced by a heart bypass machine. During the surgery, once the tear is found, artificial (synthetic) grafts replace the damaged parts of the aorta. If the aortic valve is damaged, the surgeon may also insert a replacement valve. After the process is completed, the heart bypass machine is removed, and the incision is closed.

For the endovascular method, the surgeon attaches a synthetic graft to the end of a tube (catheter). Using X-ray images as a guide, the graft is threaded through the artery to the affected part of the aorta.

Question 10

Is Aortic Dissection painful?

Accepted Answer

Typically, a patient with Aortic Dissection often complains of severe chest pain. The location of the pain indicates where the dissection has occurred. Anterior chest pain and chest pain that mimic acute myocardial infarction are usually associated with an anterior arch or aortic root dissection. A descending aorta is often indicated by tearing or ripping pain in the interscapular area. The pain typically changes as the dissection evolves.

Question 11

What does Aortic Dissection pain feel like?

Accepted Answer

Typically, Aortic Dissection presents as a sudden, severe chest, or back pain that is characterised as ripping or tearing in nature. Some might not have any pain, however most people experience severe pain. Abdominal pain can occur when the dissection affects the abdominal part of the aorta.

Question 12

How do you diagnose Aortic Dissection?

Accepted Answer

Detecting an aortic dissection can be tricky as the symptoms are similar to a variety of other health problems. Frequently used imaging procedures to diagnose Aortic Dissection include:

Transesophageal echocardiogram (TEE)

Computerized tomography (CT) scan

Magnetic resonance angiogram (MRA)

Aortic Dissection: