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Aortic Dissection

An aortic dissection is an urgent, often life-threatening, condition that requires specialized care from an experienced team. At Henry Ford Health, heart surgeons and vascular surgeons work together to quickly diagnose and treat dissections and prevent serious complications.

Why choose Henry Ford for aortic dissection treatment?

Henry Ford has one of only two dedicated aortic disease programs in southeast Michigan. We treat a high volume of patients with aortic aneurysms and aortic dissections each year, making us one of the busiest aortic surgery centers in the state and the nation.

At our Aortic Disease Program, you’ll find:

  • Care for complex conditions: Our surgeons specialize in reaching dissections in complex, delicate areas of the aorta. We perform open and minimally invasive surgery for dissections in the ascending aorta and aortic arch. These parts of the aorta are close to your heart and brain, making them difficult to treat.
  • Advanced treatments: We do complex procedures that aren’t widely available, such as reoperative or redo aortic surgery. This is a second operation to fix problems resulting from a previous emergency aortic dissection surgery. Our surgeons routinely treat these high-risk patients with excellent outcomes.
  • Experts in emergency aortic surgery: Our team is available 24/7/365 to perform urgent surgery for aortic dissections and aneurysms. You recover in our cardiac intensive care unit (CICU). Intensivists and their teams provide you with the highest level of specialized care after heart surgery.

What is an aortic dissection?

The aorta is the body’s largest artery, carrying blood from your heart to the rest of your body. The wall of the aorta has several layers. An aortic dissection is a tear in one of the layers, allowing blood to leak between the layers.

Although aortic dissections aren’t as common as aortic aneurysms, they’re much more dangerous. Dissections require immediate medical attention. Blood between the layers of the aorta can cause the vessel to rupture (burst), leading to life-threatening bleeding. A dissection can also divert blood away from the branching arteries of the aorta that supply blood to your vital organs such as the heart, brain, kidneys and liver.

Types of aortic dissections

Aortic dissections can be acute or chronic. Acute aortic dissections cause sudden, severe symptoms and need urgent treatment. Chronic aortic dissections develop over time and cause milder symptoms. Chronic dissections still need treatment but aren’t usually life-threatening.

We further classify aortic dissections as type A or type B:

  • Type A aortic dissections occur in the ascending aorta, the first part of the aorta that connects to your heart. Type A dissections are usually acute.
  • Type B aortic dissections occur in the aortic arch or descending aorta, which runs through your chest and abdomen. Type B dissections are usually chronic.

Aortic dissection causes and risk factors

Traumatic injuries to your chest can cause sudden aortic dissections. However, it’s more common for certain medical conditions to damage or weaken the walls of the aorta. Most aortic dissections occur in people between the ages of 50 and 65.

Aortic dissection risk factors include:

  • Atherosclerosis (hardening of the arteries)
  • Chronic high blood pressure or a sudden, severe increase in blood pressure
  • Congenital (from birth) heart defects such as bicuspid aortic valve and coarctation of the aorta
  • Genetic conditions such as Marfan, Turner and Ehlers-Danlos syndromes
  • Heart surgery such as coronary artery bypass or valve replacement
  • Personal or family history of aortic aneurysms or dissections
  • Smoking

Aortic dissection symptoms

Symptoms of an aortic dissection may include:

  • Chest or upper back pain that feels sharp and intense
  • Difficulty speaking
  • Dizziness or fainting
  • Leg pain, paralysis or difficulty walking
  • Nausea and vomiting
  • Rapid, weak pulse
  • Shortness of breath
  • Vision loss

Aortic dissection diagnosis

Some aortic dissections are difficult to diagnose because their signs and symptoms mimic those of other conditions, including heart attacks. At Henry Ford, our aortic disease specialists are experts at distinguishing symptoms to pinpoint an aortic dissection. We use the latest imaging technology — including CT scans, MRI and echocardiography — to diagnose aortic dissections as quickly as possible.

Learn more about how we diagnose aortic diseases.

Aortic dissection treatment at Henry Ford

Surgery is the main treatment for aortic dissections. Most people also receive medication to lower their blood pressure and reduce the risk of a rupture.

Acute type A dissections (in the ascending aorta) usually require open aortic surgery. People with chronic type B dissections (in the descending aorta) may be candidates for minimally invasive treatment. At Henry Ford, our surgical capabilities mean we can often combine open aortic surgery and endovascular repair as a hybrid treatment for complex conditions and high-risk patients.

Learn more about our options for aortic disease treatment.

Take the next step

Request an appointment with a member of our aortic disease team or use one of the numbers below:

  • Detroit or southeast Michigan: (844) 725-6424
  • Jackson or south central Michigan: (517) 205-1305
What is an Aortic Dissection?

Dr. Loay Kabbani, a Vascular Surgeon at Henry Ford Health discusses aortic dissection, what causes it and how to prevent it.

HVI aortic CTA Play
  • What is an aortic dissection?

    As the largest artery, the aorta carries oxygen-rich blood from the heart to smaller arteries that run throughout the body. The aorta leads upward from the heart, curves into an arch and then goes down through the chest and abdomen to the pelvis.

    The aorta’s wall is lined with three layers: inner, middle and outer. An aortic dissection develops when the inner layer tears, allowing blood to flow between it and the middle layer. The force of the flowing blood creates a channel that can burst (rupture) through the outer layer and cause massive internal bleeding.

    Aortic dissections require immediate medical attention because many have the potential to rupture. If left untreated, aortic tears can lead to serious complications, including:

    • Organ damage such as kidney failure or intestinal problems, due to reduced blood flow
    • Stroke
    • Aortic heart valve damage (aortic regurgitation)
    • Pressure on the heart from blood building up in the lining that surrounds it, a condition called cardiac tamponade
    • Death due to internal bleeding
  • What causes an aortic dissection?

    Aortic dissections are rare. When they do occur, they tend to develop more frequently in the thoracic aorta (upper aorta in the chest). The most common cause is chronic high blood pressure that damages and weakens the aorta’s walls over time.

    Other causes of aortic dissections include:

    • Certain genetic conditions: Connective tissue disorders can weaken the aorta’s walls. These conditions include Marfan syndrome, Ehlers-Danlos syndrome, Loeys-Dietz syndrome and Turner syndrome.
    • Congenital heart defects: Some people are born with abnormal structures in the heart that increase the risk of dissection. Defects include a bicuspid aortic valve (with two flaps instead of three) or a narrowed section of aorta (coarctation of the aorta).
    • Trauma to the chest: Blunt force trauma, like the type that occurs in serious falls or car accidents, can cause an aortic dissection.

    Risk factors for aortic dissection

    Factors that can increase the risk of an aortic dissection include:

    • Hardening of the arteries (atherosclerosis), a condition in which cholesterol, fat and other substances build up inside artery walls
    • Aortic aneurysm
    • Age (typically 65 and older)
    • Smoking
    • Cocaine use
  • Symptoms of an aortic dissection

    Symptoms occur suddenly and are severe at times. They include:

    • Sharp, intense chest or upper back pain — can feel like tearing or ripping and can spread elsewhere in the back or to the neck
    • Dizziness or fainting
    • Shortness of breath
    • Rapid, weak pulse
    • Leg pain, paralysis or difficulty walking
    • Nausea and vomiting
    • Symptoms like those of a stroke — difficulty speaking, vision loss, or weakness or paralysis on one side of your body
  • How do doctors diagnose an aortic dissection?

    Some aortic dissections are difficult to diagnose because their signs and symptoms mimic those of other conditions, including heart attacks. At Henry Ford, our vascular specialists are experts at distinguishing symptoms to pinpoint an aortic dissection diagnosis. Learn more about our vascular testing and our process for aortic disease diagnosis.

  • Aortic dissection treatment at Henry Ford

    The Multidisciplinary Aorta Program is one of the few programs in Michigan offering all available options for dissections. Treatments include medications, minimally invasive procedures and open surgery.

    Aortic dissections require immediate, emergency medical care. We typically begin treatment with medications to quickly reduce blood pressure and heart rate. Further treatment varies and depends on where the dissection occurs:

    Type A dissections

    Type A dissections occur in the ascending aorta (section nearest the heart, including the aortic arch). We usually repair or replace the torn area using open surgery.

    In some cases, our surgeons can perform a minimally invasive procedure to repair or replace the torn area. We take an endovascular approach, working inside the aorta with a catheter. This thin, flexible tube is inserted through a needle puncture or tiny incision.

    Type B dissections

    Dissections in the descending aorta (section past the aortic arch that runs through the chest and abdomen) are type B. Treatment recommendations depend on the dissection’s severity. Our options include:

    • Continuing medications to lower blood pressure and heart rate
    • Performing an endovascular procedure
    • Doing open surgery for more serious warning signs, such as blood leaks or reduced blood flow to the organs or legs

    Minimally invasive repair for aortic dissection

    For aortic dissections that are repairable with endovascular procedures, our surgeons offer:

    Open surgery for aortic dissection

    Our vascular surgeons and cardiac surgeons have advanced training and experience in open surgery to treat aortic dissections. Find out more about open surgeries for aortic disease treatment and vascular surgery available to you at Henry Ford.

  • Follow-up care for aortic dissection

    After procedures, you’ll see our vascular medicine specialists and cardiologists for follow-up care and ongoing monitoring. We ensure that your blood pressure is under control and adjust your medications as necessary.

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