Aortic Dissection: Symptoms, Causes and Treatment
An aortic dissection is a medical problem involving your aorta, which is your body’s biggest blood vessel and the major artery that transports blood from your heart to the other parts of your body. The innermost layer of the aorta breaks during an aortic dissection, allowing blood to enter places it should not. As a result, the inner and middle layers separate, or dissect. If blood breaks through into the external wall of your aorta, it is life threatening and must be treated immediately.
Types of Aortic Dissection
- Type – A Aortic Dissection: This form of dissection happens in the early segment of the aorta, closer to the heart, and can be fatal. Emergency open heart surgery is frequently required to repair or replace the initial section of the aorta where the tear occurred(ascending aorta +/- arch and/or aortic valve). This is a more common kind of dissection than Type B, as the aorta dissection generally runs the whole length of the aorta.
- Type – B Aortic Dissection: This form of tear starts further down the aorta (the descending aorta further than the arch) and away from the heart. This form of dissection, like the type A dissection, frequently spreads from the descending aorta into the abdominal aorta, but does not include the beginning phase of the aorta at the front of the chest. Based on where the dissection is and whether or not it is shutting off blood supply to your organs, treatment may or may not be required right away. These procedures are often conducted using a stent-graft device placed into the aorta.
Symptoms of Aortic Dissection
Aortic dissection can be fatal. Approximately 40% of people die promptly from aortic dissection and hemorrhage. The risk of death might range from 1% to 3% every hour until the patient is given care. If you experience aortic dissection symptoms, severe chest pain, or stroke symptoms, seek immediate care. When a diagnosis is determined, you might well be moved to a referral facility with the capability to address these complicated illnesses by a critical care transport team.
- Difficulty in breathing
- Loss of consciousness
- Extreme release of sweat
- Severe abdominal pain
- Chest pain
- Difficulty speaking
- Vision problems
- Pale skin
- Difficulty walking
- Weakness on one side of the body
- Low blood pressure
Causes of Aortic Dissection
Aortic dissection occurs as a result of a steady disintegration of the cells that comprise the lining of your aorta. The breakdown has most likely been occurring silently for many years until the weakest portion of the aorta wall ultimately breaks away, resulting in a rip and aortic dissection. In some cases, the aorta weakens due to birth defects that impair its strength or size. In rare situations, it is caused by a catastrophic injury to the chest, such as in a vehicle accident.
Who is at risk of developing Aortic Dissection?
Aortic dissections more commonly strike males aged 60 to 80. Men are twice as likely as women to develop an aortic dissection. Other factors that increase the likelihood of an aortic dissection include:
- High blood pressure
- Hardening of the arteries
- Weakened artery
- Pre-existing Bulging
- Aortic coarctation
- Family history of Aortic dissection
- Traumatic Injury in the chest
- Vasculitis (An inflammatory condition affecting the body’s blood vessels)
- People dealing with Turner’s syndrome
- Use of cocaine during pregnancy, and high-intensity weight lifting can also increase the chance of developing Aortic Dissection
Complications from Aortic Dissection
- Aortic valve damage
- Buildup of the fluid between the heart muscles and the sac
- Kidney failure
- Respiratory issues
- Side effects due to anesthesia
Aortic Dissection Treatment
Treatment procedure for Aortic Dissection depends on the location of the dissection and the tear. Type A aortic dissection necessitates immediate surgery whereas for Type B aortic dissection necessitates emergency surgery if it shuts off blood supply to important organs such as intestines, legs, kidneys, even spinal cord. If specific high-risk traits are seen on CT scan imaging, immediate surgery is required. Less severe instances may be treated with medicines first, postponing surgery until problems arise. When it comes to these treatment options, surgical therapies are always preferable to medicinal treatments. Surgical therapy is the preferred option in emergency conditions such as severe aortic dissection.
Endovascular stent-graft repair: A stent graft, which is a synthetic fabric tube anchored by fine metal stents (similar to a scaffold), is employed to fix the aorta from inside. Endovascular surgery includes repairing your aorta from inside. A tiny incision is made in your groin, and an x-ray-guided catheter with the fabric-lined stent connected is delivered and inserted into the aorta. The stent graft is loosened at the repair site and, like a spring or umbrella, expands up, relining and reinforcing the weak spot in the aorta.
A hybrid approach is employed to repair the aorta by combining traditional surgical intervention with an endovascular stent-graft technique. When the restoration must extend into the aortic arch, where branch arteries to the brain and limbs emerge, this technique is employed. This can be done as an emergency procedure for Type A dissection or as a two-stage procedure with a diversion from a vessel in the neck to assist set up an endovascular repair for Type B dissection. The elephant trunk operation is one of the most prevalent hybrid treatments. First, the aorta segment closest to the heart and the aortic arch are replaced and mended.
Endovascular procedures are less invasive and require less time. Because a smaller region is exposed during the operation, the odds of post-procedural infections are much lower than with open surgical repair.
Dr. Abhilash Sandhyala is a well-known Interventional radiologist, varicose veins expert in Hyderabad, and the top endovascular surgeon in Hyderabad. His objective is to deliver high-quality, tailored healthcare. We have established a practice in which we have faith. We are proud and certain of our procedures. We would never return to do the same treatments on our own family members!
Dr. Abhilash Sandhyala is a full-time Vascular Specialist in Hyderabad who believes in collaborating with his patients to maintain and enhance their health. To obtain the greatest outcomes, he believes in offering complete healthcare services to his patients in a courteous manner. With his experience he had successfully treated thousands of patients dealing with Aortic Dissection, Varicose Veins, Foot Ulcers and many other chronic diseases. If you are experiencing any of the above mentioned symptoms do contact our experts and we will help you to overcome them.