The aorta is the largest blood vessel in your body. It travels up (ascends) from your heart, curves, then descends to your abdomen. Arteries branch off the aorta. They supply your head, arms, internal organs and legs with oxygen-rich blood.

The aortic wall has three layers. Aortic dissection occurs when the inner layer of the aorta tears. Blood enters the space between the layers, creating a separate channel.

There are two types of aortic dissection. They include:

• Type A: This type occurs in the part of the aorta that travels up (ascends) or its curve (arch).
• Type B: This type occurs in the part of the aorta that runs down (descends) through your chest and abdomen.

Aortic dissection can:

• Block blood flow through the main channel of the aorta or to branching arteries
• Damage the aortic valve, which controls blood flow from the heart into the aorta
• Weaken the aortic wall, causing it to balloon out (aortic aneurysm) or burst (rupture)

Because these complications can be life-threatening, aortic dissection requires emergency evaluation and treatment.

Aortic dissection is a medical emergency. Symptoms vary based on the location and extent of damage to your aorta and other structures.

Emergency Symptoms 

Call 911 immediately if you or a loved one experiences:

• Severe, sudden pain of the chest, back or abdomen  
• Fainting 
• Shortness of breath (dyspnea) 
• Weakness or tingling in the limbs 

Aortic dissection is caused by a tear at a weak spot in the aortic wall. Many health conditions and factors can weaken the aorta and increase your risk for aortic dissection, including:

There are some factors that can increase your risk for aortic dissection, including:

To diagnose aortic dissection, your physician asks about your symptoms and medical and family history. You also have a physical exam.

Imaging tests are essential tools in diagnosing aortic dissection. They include:

• CT scan
• Transesophageal echocardiogram (TEE), which uses produces detailed images of your thoracic aorta

Your physician may also recommend genetic testing to assess your risk. A genetic test looks for abnormal changes (mutations) in certain genes associated with aortic dissection.

Your care team will recommend treatment based on the location of the dissection. You may receive:

• Emergency surgery for Type A dissections to repair the damaged aorta
• Immediate repair if a Type B dissection cuts off blood flow to a vital branching artery. (This could mean an open-heart surgery or a stent.)

For less severe Type B dissections, your physician may recommend medications, lifestyle changes and monitoring. Together, you can develop a personalized treatment plan.

Aortic Dissection Surgery

Aortic dissection surgery involves removing the damaged section of your aorta and replacing it with a fabric tube (graft). Our surgeons use specialized grafts to match your aorta and its branching arteries. They may also replace a damaged aortic valve, which is the doorway between the heart and the aorta.

Aortic dissection surgery is complex and requires extensive skill. Our surgeons are renowned for their expertise in performing advanced aortic surgery, while achieving excellent patient outcomes.

Endovascular Aortic Dissection Repair

Endovascular repair is often an option for Type B dissections that occur in the descending aorta.

A vascular surgeon inserts a thin tube (catheter) into a leg artery to reach your aorta. A collapsed stent (covered metal mesh tube) passes through the catheter and expands inside the aorta. The stent seals the false pathway and provides long-lasting support.

Our specialists perform two main types of endovascular procedures for aortic dissection repair:

• Endovascular aortic repair (EVAR) for aortic dissections in your abdomen
• Thoracic endovascular aortic repair (TEVAR) for aortic dissections in your chest

Large dissections that involve both the curve (arch) and descending aorta may require surgery and endovascular repair. Our skilled teams work together seamlessly to provide this advanced hybrid approach.  

Aortic Dissection Follow-Up Care

If you have an aortic dissection, your physician monitors you closely for additional changes in your aorta. Your care includes regular visits and imaging tests. Those could include one or more of the following: 

• CT scans
• MRI
• echocardiogram
• ultrasound

Blood pressure and heart rate control are essential after an aortic dissection. Your physician may prescribe medications if you have high blood pressure (hypertension). You may also be advised to avoid intense activity and heavy lifting.

Aortic dissection is not always preventable, especially if you have certain genetic conditions.

Lowering your blood pressure and heart rate may help prevent aortic dissection, since it's a key risk factor. If you have high blood pressure or a high heart rate, you can work with your physician to bring these levels down.

Steps you can take include:

• Eating a healthy diet
• Getting in a routine of gentle aerobic exercise
• Maintaining a healthy weight
• Quitting smoking
• Taking medications as directed
• Avoiding heavy weightlifting and other strenuous activities