Surgical Treatment of Dissection
If there is failure to control symptoms or complications from dissection with medicine, life threatening or limb threatening compromise of blood flow to vital structures, or unmanagable doses of medical treatment is required, then surgical intervention is usually required.
TType A Dissection
When the dissection affects the part of the aorta closest to the heart it is called Type A. It threatens heart function and it is usual for the patient to undergo corrective emergency open heart surgery performed by Cardiac Surgeons. They operate to prevent the main valves of the heart from failing and to protect the coronary arteries from being compressed by pressure from blood in the vessel wall. Even with this life saving surgery one in four patients do not survive 30 days; without surgery less than one in four will survive just two weeks. The operation involves the replacement of the aorta, and sometimes the major heart valve, with an artificial replacement