Advanced Management of Aortic Dissection

An aortic dissection — also referred to as dissecting aorta or dissecting aneurysm — is a serious condition where the inner layer of the aorta tears and blood is rerouted through the tear, causing the inner and middle layers to separate. Aortic dissections are potentially fatal because the tear can decrease the amount of oxygen that is delivered to vital organs, such as the brain, heart, kidneys and intestines.

aortic dissection
Aortic dissection

Though aortic dissections are relatively rare, University of Chicago Medicine vascular surgeons are experts at recognizing and treating this condition.

Causes of Aortic Dissection

Aortic dissections are often the result of a weakening in the aortic wall, which can be associated with a number of common risk factors, including:

  • Aortitis (inflammation of the aorta)
  • Atherosclerosis (narrowing of the aorta due to hardened plaque)
  • Bicuspid aortic valve (the presence of only two cusps, or leaflets, in the aortic valve, rather than the normal three cusps)
  • Coarctation of the aorta (narrowing of the aorta)

  • Connective tissue disorders, such as Marfan syndrome, Ehlers-Danlos syndrome and Turner's syndrome

  • Cystic medial disease (a degenerative disease of the aortic wall)
  • Existing aneurysm
  • Hypertension (high blood pressure)
  • Polycystic kidney disease (a genetic disorder characterized by the growth of numerous cysts filled with fluid in the kidneys) 

  • Trauma

Symptoms of Aortic Dissection

Symptoms of an aortic dissection may be confused with symptoms of other heart conditions, such as a heart attack. The most commonly reported sign of an acute aortic dissection is severe, constant chest and/or upper back pain, sometimes described as a "ripping" or "tearing" sensation. The pain may be migratory, moving from one place to another, according to the direction and extent of the dissection. Other indications include loss of consciousness, leg or arm weakness and/or severe uncontrolled high blood pressure.

Treatment of Aortic Dissections

In the event of a suspected dissection, our physicians may recommend medications to manage blood pressure in order to prevent the dissection from worsening.

For dissections that require surgery, the UChicago Medicine offers expert-level skill in a wide range of surgical treatments:

  • Advanced cardiopulmonary perfusion techniques for cerebral and spinal cord protection
  • Biologic composite grafts 
  • Open, endovascular and hybrid repair 
  • Valve repair and valve-sparing aortic roots (the David procedure)