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Treatments and drugs
By Mayo Clinic staffAn aortic dissection is a medical emergency requiring immediate treatment. Therapy may include surgery or medications, depending on the area of the aorta involved.
Type A aortic dissection
Type A aortic dissections are the more common and dangerous type of aortic dissection. These dissections involve a tear in the ascending portion of the aorta just where it exits the heart or a tear extending from the ascending portion down to the descending portion of the aorta, which may extend into the abdomen. Surgery is the preferred treatment for type A aortic dissections.
During the surgical procedure, surgeons remove as much of the dissected aorta as possible, block the entry of blood into the aortic wall and reconstruct the aorta with a synthetic tube called a graft. Some people with type A aortic dissection will need to have their aortic valve replaced at the same time if there's valve leakage related to the damaged aorta. If aortic valve replacement is required, the valve is placed within the graft that is used to reconstruct the aorta.
Type B aortic dissection
This type of aortic dissection involves a tear in the descending aorta only, which may also extend into the abdomen. People with type B aortic dissection can be treated medically or with surgery. Surgical options for type B aortic dissection are similar to the procedures used to correct a type A aortic dissection. Sometimes stents — small wire mesh tubes that act as a sort of scaffolding — may be placed in the aorta to repair type B aortic dissections.
Medications for aortic dissection
Aortic dissections may be treated with medications, such as beta blockers and sodium nitroprusside (Nitropress), to relieve the force of blood on the aortic wall by reducing the heart rate and lowering blood pressure. With reduced blood force, the aortic dissection is less likely to worsen. These medications may be used to prepare a person for surgery. Most people with type B dissections can be treated with medications alone.
After treatment many people with aortic dissections need to take blood pressure lowering medication for the rest of their lives. In addition, they'll often need follow-up CT or MRI scans periodically to monitor their condition. How often you'll need imaging tests depends on your underlying condition.
- Braverman AC, et al. Diseases of the aorta. In: Bonow RO, et al. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-1-4377-0398-6..C2009-0-59734-6--TOP&isbn=978-1-4377-0398-6&about=true&uniqId=236798031-10. Accessed Sept. 15, 2011.
- Ankel F. Aortic dissection. In: Marx JA, et al. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa.: Mosby Elsevier; 2010. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-0-323-05472-0..X0001-1--TOP&isbn=978-0-323-05472-0&uniqId=230100505-57. Accessed Sept. 15, 2011.
- Manning WJ. Clinical manifestations and diagnosis of aortic dissection. http://www.uptodate.com/home/index.html. Accessed Sept. 15, 2011.
- Manning WJ. Management of aortic dissection. http://www.uptodate.com/home/index.html. Accessed Sept. 15, 2011.
- Prevention: What you can do. Centers for Disease Control and Prevention. http://www.cdc.gov/heartdisease/what_you_can_do.htm. Accessed Sept. 15, 2011.
- Loeys-Dietz syndrome. Johns Hopkins Medicine. http://www.hopkinsmedicine.org/heart_vascular_institute/conditions_treatments/conditions/loeys_dietz.html. Accessed Oct. 4, 2011.
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