Management of Type B Aortic Dissection
Publication Date: January 25, 2022
This patient summary means to discuss key recommendations from the Society of Thoracic Surgeons for the Management of Type B Aortic Dissection (TBAD).
- Aortic dissection describes a tear in the inner lining of the aorta that allows blood to dissect (flow) into the wall of the aorta. This can stop blood flowing to vital organs.
- Throughout this summary, we will use the abbreviations SCI for spinal cord ischemia (inadequate blood supply), TEVAR for thoracic endovascular aortic repair, and TBAD for type B aortic dissection.
- Some of the most common causes of aortic dissection are common cardiovascular disease, sustained high blood pressure, smoking, Marfan syndrome, and other congenital cardiovascular conditions.
- Symptoms include sudden severe tearing back pain and fainting.
- This patient summary focuses on the management of type B aortic dissection.
- The initial assessment must include the blood supply to every threatened organ, especially the spinal cord.
- Your general health and any additional medical conditions must be evaluated.
- The urgency of the threat will affect how soon surgical repair can begin.
- There are several treatment choices:
- Optimal medical therapy (OMT) without surgery can be considered if your situation is not immediately life-threatening.
- OMT is often added after surgical repair to prevent recurrent dissection.
- OMT includes medications to control blood pressure.
- Thoracic endovascular aortic repair (TEVAR) is favored if judged to be effective.
- TEVAR describes inserting a long, thin device into your aorta, usually, through a small incision in the artery in your groin, that can implant a stent (an expandable wire tube) to seal the tear and prevent further damage
- Open surgical repair is a major undertaking.
- Fenestration describes creating another opening in the inner lining of the aorta so that blood can flow out of the blind pocket created by the initial tear and re-enter its normal channels.
- Additional procedures may have to be done to assure that the blood supply to the spinal cord or other organs is preserved or re-established.
- OMT: Optimal Medical Therapy
- SCI: Spinal Cord Ischemia
- TBAD: Type B Aortic Dissection
- TEVAR: Thoracic Endovascular Aortic Repair
MacGillivray TE, Gleason TG, Patel HJ, Aldea GS, Bavaria JE, Beaver TM, et al. The Society of Thoracic Surgeons/American Association for Thoracic Surgery clinical practice guidelines on the management of type B aortic dissection. J Thorac Cardiovasc Surg. 2022;XXX:XX-XX.
The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.