A Leader in Treating Aortic
Dissection
Aortic
dissection – also known as an aortic aneurysm – is a rare, serious condition
that involves the aorta, the body’s largest blood vessel.
The aorta is made up of three layers: the inner layer (tunica intima), the
middle layer (tunica media), and the outer layer (tunica adventitia). An aortic
dissection occurs when blood breaks through the inner layer and ends up between
two layers.
Aortic dissections
can occur in different sections of the aorta and be either acute or chronic. The
condition also can cause a widening (aneurysm) of the aorta.
UT
Southwestern is a recognized leader in evaluating, diagnosing, and treating
aortic dissection. Our team developed the fenestrated (branched) endograft, a
procedure that facilitates blood flow to the blood vessels that branch off the
aorta. UT Southwestern is one of only a handful of U.S. centers offering and
researching this state-of-the-art technique.
We’re home
to a hybrid operating room equipped with angiographic imaging equipment that
provides real-time visualization of blood vessels. This technology enables
doctors to view the patient’s anatomy and determine in real time the most
appropriate treatment.
UT
Southwestern also offers a dedicated Cardiac Rehabilitation Program. Cardiac rehabilitation is a
critical component of recovery and can prevent future heart disease.
Causes and Symptoms
Causes of
aortic dissection include:
- Atherosclerosis: Hardening of the arteries, also known as arteriosclerosis
- Congenital heart diseases: Defects that begin during fetal
development
- Ehlers-Danlos syndrome: An inherited disorder marked by loose joints, easily bruised skin, and
easily damaged blood vessels
- High blood pressure (hypertension): A
condition that makes the heart work harder to pump blood through the body and
can cause the heart to fail if not treated
- Marfan syndrome: The most common inherited disorder of the connective tissue
- Medical procedures: Problems that develop following insertion
of a catheter or during surgery
- Trauma: Severe injuries, such as a puncture or laceration
during an automobile or industrial accident or a gunshot wound
Symptoms of aortic dissection can include:
- Severe, often sudden pain in the chest (angina), shoulders,
back, abdomen, arms, neck, hips, or legs
- Stroke-like
symptoms
- Difficulty swallowing
- Sweating
- Anxiety
- Decreased
sensation
- Nausea
- Pale skin
(pallor)
- Rapid heart rate
(tachycardia)
- Shortness of
breath (dyspnea)
Diagnosis
UT
Southwestern’s care team uses several tests to determine the problem. Common
diagnostic tests include:
- Computed tomography angiography (CTA): Shows detailed images of the aorta and other arteries
- Blood pressure measurement: Detects low blood pressure
- Chest X-ray or ultrasound: Shows aortic abnormalities
- CT scan with contrast dye: Provides detailed views of aortic abnormalities
- Stethoscope: Detects
issues such as aortic murmurs and weak pulses at extremities
Treatments
Depending
on the severity of the problem, aortic dissections can be treated in a number
of ways, such as:
- Aortic valve
replacement, if
necessary
- Surgery to
replace the damaged aorta with a graft
- A hybrid approach that combines endovascular and traditional open surgical
techniques
- Fenestrated or
branched endograft, a procedure that allows blood to flow to blood vessels
that branch off the aorta
- Beta blockers, a
class of drugs used to treat certain heart conditions
- Anti-hypertensive
medications to lower blood pressure
- Pain-relief
medications
Clinical
Trials
Eligible patients have opportunities to participate in
clinical trials of the
most promising new treatments for heart disease.
As one of
the nation’s top academic medical centers, UT Southwestern offers a number of
clinical trials aimed at improving the outcomes of patients with a variety of cardiovascular
conditions.
Clinical
trials often give patients access to leading-edge treatments that are not yet
widely available. Eligible patients who choose to participate in one of UT
Southwestern’s clinical trials can receive treatments years before they are
available to the public.