What Is the Procedure for Repairing an Aortic Dissection?

There are several options for repairing or replacing a section of the aorta that has been damaged by a dissection. The procedure chosen will be determined by factors such as the location of the dissection, the amount of aorta that needs to be repaired or replaced, and your overall health. Your surgeon will decide which of the following procedures is best for you based on your specific circumstances:

Open-Heart Surgery

Making a 7- to 10-inch incision over the middle of the sternum, or breastbone, and separating the sternum to provide access to the heart is required to treat aortic dissection. In rare circumstances, a less invasive procedure with a smaller sternal incision may be possible. In either situation, the injured piece of your aorta is replaced with a graft, which is a tube the same size as your aorta made of a strong artificial material like Dacron that is sutured or sewed, into place.

During the process, your heart will be stopped from beating so that the operation can be performed in a motionless and bloodless environment; while your heart is stopped, a device called a heart-lung bypass machine will take over your heart’s function and keep your circulation going.

Endovascular Surgery

Patients with a descending aorta dissection may benefit from this procedure. This minimally invasive procedure involves making a couple of small incisions in your groin blood vessels, inserting long, thin tubes known as catheters through the vessels to the point where your dissection is located, and then using X-ray guidance and long, thin instruments threaded through the catheters to place a small mesh tube known as a “stent graft” inside the affected portion of the vessel.

Endovascular surgery can occasionally be performed with the patient under local anesthesia rather than general anesthesia in certain conditions; it also does not require hypothermic circulatory arrest or the use of a heart-lung bypass machine. Because this method avoids opening the chest at all, it usually results in a significantly faster recovery.

Valve Sparing Surgery

It can be considered for procedures on the aortic root, the section of the aorta nearest to the heart. This treatment simply replaces the injured segment of the aorta, not the aortic valve; it is thus only appropriate for individuals who have an undamaged or repairable aortic valve. A composite transplant is an approach that involves not only replacing the dissected part of the aorta but also replacing the aortic valve with a mechanical valve.

Read More – Know Everything About Transcatheter Aortic Valve Implantation In India

What Are the Risks of Aortic Dissection Repair?

The tear can have an impact on your brain, lungs, arms, legs, and heart over time. This is determined by the location of the tear in your aorta. Treatment is also determined by the location of the tear. If the tear is on the ascending aorta, surgery will almost certainly be required. This is the section of the aorta that runs through your chest and up to your head.

Aortic dissection is caused by a number of reasons, including:

• High Blood pressure 
• An accident-related injury
• Genetic disorders that are passed on via the generations
• Atherosclerosis
• Aortic Aneurysm
• Heart problems due to structural issues
• Smoking

Other risks may exist, depending on your medical condition. Before the procedure, make sure to share any concerns you have with your healthcare professional. Problems might arise with any procedure. The following are some examples of potential complications:

• Stroke
• Cardiac Arrest
• Infection of lungs
• Risk of Anesthesia
• Bleeding
• Damage to internal organs
• Death

How Prevention of Aortic Dissection Is Done?

Many of the factors that raise the risk of aortic dissection, such as being born with specific heart diseases, connective tissue disorders, or genetic triggers linked to a family history of aortic dissection, cannot be changed. However, as with many other medical conditions and diseases, you can reduce some of your risks by altering the risk factors that can be controlled. Among the concerns are:

• Lowering high blood pressure to a target of 120/80 mm/Hg with medication, dietary modifications, and other treatments suggested by your doctor.
• Maintaining a healthy weight while quitting smoking/using tobacco products.
• Wearing your seat belt to protect your chest from damage in the event of an accident.

Visiting your doctor for routine check-ups and any other time you notice a change in your health.

It’s important to screen first-degree relatives of someone who has had an aortic dissection for their risk of developing the aortic disease. Before an aortic event happens, it can be properly monitored and treated.

Conclusion

It’s possible that you’ll require at least one month to recover following your surgery. For the first week, you will be in the hospital. Until your vital signs are stable, you will most likely be in the intensive care unit (ICU). Before going home, you will be transferred to a regular nursing unit to finish your treatment. You may require medications for nausea, pain, and discomfort throughout your hospital stay.

Make arrangements for someone to drive you home. It’s possible that you shouldn’t get behind the wheel immediately away. Inquire with your provider about when you’ll be able to drive again.