Though fewer than 200,000 cases are reported in the United States each year, aortic dissection is a serious condition of the aorta that can be life threatening. Aortic dissection occurs when the innermost layer of the aorta tears. Naturally, when this happens, blood begins to flow through the tear, resulting in the separation (dissection) of the inner and middle layers of the aorta. Perhaps the greatest concern regarding aortic dissection is rupture. This happens when blood flowing through the dissected aorta pushes through the outside aortic wall. Without a doubt, an aortic rupture can prove fatal.
Dissection of the aorta most often occurs in the thoracic (chest) section of the artery, yet it may occur in the abdominal aortic region. Even so, dissection happens when a section of the aortic wall is weakened. While aging, atherosclerosis and high blood pressure are common risk factors, and other conditions put individuals at risk for weakened aortic walls or blood vessels. A few examples are Marfan syndrome, bicuspid aortic valve, narrowing of the aorta, pregnancy, heart surgery, arteritis and syphilis.
While advancements in diagnostic testing and treatment of aortic dissection have resulted in early detection and the saving of lives, symptoms of aortic dissection closely mimic other heart-related conditions. Consider the following:
- Severe pain in the chest or upper back (may be sudden). The pain may be described as a ripping or tearing sensation, and pain may move to the neck and down the back.
- Shortness of breath
- Loss of consciousness
- Weakness or paralysis on one side of the body
- Difficulty speaking (may be sudden and resemble a stroke)
- Loss of vision
- Weak pulse in one arm (in comparison to the other)
With extensive expertise in vascular diagnosis, Dr. Alan I. Benvenisty, MD is a distinguished general and vascular surgeon with added qualifications in aortic conditions. With a conscientious, patient-centered approach, Dr. Benvenisty treats his patients as individuals. He understands that proper diagnosis is key to a determining an appropriate treatment. To schedule an appointment, patients are encouraged to contact Dr. Benvenisty as his office in New York City on Amsterdam Avenue.
Treatment Options for Aortic Dissection
While treatment for aortic dissection should be given right away, it may or may not involve surgery. Advancements in diagnostic testing and screening provide invaluable insight when developing a suitable treatment plan. Some examples include aortic angiography, x-rays, MRI, CT scans, Doppler ultrasound, echocardiogram and transesophageal echocardiogram (TEE).
To better understand, dissections occurring in the ascending aortic valve (leaving the heart) are typically treated with surgery. Surgical techniques include open repair surgery or an endovascular aortic repair procedure. Standard, open surgery is more of a traditional approach but requires an incision. It is not the best option for all patients. On the other hand, endovascular repair is less invasive and is performed without a major incision. Even so, when dissection occurs in the descending aortic valve, surgery may not be required at all. In some cases, descending aortic dissections are successfully managed with medication.
Treatment options for aortic dissection vary from patient to patient. Thus, there’s not a one-size-fits-all approach to treatment or surgery. For instance, in the event that the aortic valve is damaged, the valve will need to be replaced. In turn, if the arteries are also damaged, additional forms of surgery may be necessary. For every treatment option, there are also possible complications, and long-term care and assessment of the aorta may be necessary.
When considering the seriousness of aortic dissection, it’s important to commit to regular examinations and checkups if you have risk factors or health conditions that are associated with dissection.
Providing conscientious care to patients in New York City, Dr. Alan Benvenisty is a highly respected general and vascular surgeon with a specialty in vascular diagnosis and non-surgical, non-invasive treatments. Dr. Benvenisty commits to the philosophy of treating patients as individuals, and he dedicates ample time to each patient. To schedule an appointment with Dr. Benvenisty, contact our office on Amsterdam Avenue today.