An aortic dissection is a life-threatening condition that occurs when the inner layer of the aorta tears, allowing blood to flow between the layers of the artery wall. This creates a false channel that can block blood flow to critical organs or cause the aorta to rupture.
At UHealth – University of Miami Health System, patients with suspected aortic dissection receive immediate, expert care from a multidisciplinary team that includes vascular surgeons, cardiothoracic surgeons, cardiologists, and interventional radiologists. We combine rapid imaging, minimally invasive stent repair, and advanced open surgery to manage both acute and chronic dissections and support long-term recovery.
What Is an Aortic Dissection?
The aorta is the body's largest artery, extending from the heart through the chest and abdomen. It has three layers:
- Intima – inner lining
- Media – muscular middle layer
- Adventitia – outer protective layer
A dissection happens when a tear forms in the intima, and blood forces its way between the layers, separating them.
Types of Aortic Dissection
- Type A Dissection: Involves the ascending aorta (closest to the heart). This is a surgical emergency requiring immediate intervention.
- Type B Dissection: Involves the descending aorta (farther from the heart). May be treated with medication, stent placement, or surgery depending on severity and complications.
Causes and Risk Factors of Aortic Dissections
Aortic dissections can happen suddenly, but several factors increase risk:
- High blood pressure (hypertension): The most common risk factor, present in up to 75% of patients.
- Aortic aneurysm: A weakened, bulging area of the aorta increases the chance of tearing.
- Connective tissue disorders: Conditions such as Marfan syndrome, Loeys-Dietz syndrome, or Ehlers-Danlos syndrome weaken the vessel wall.
- Atherosclerosis: Hardening and narrowing of the arteries over time.
- Trauma: Blunt injury to the chest, often from a car accident.
- Family history or genetic predisposition: Inherited aortic disease increases risk at a younger age.
- Lifestyle factors: Smoking, uncontrolled high cholesterol, and stimulant drug use (such as cocaine) raise risk.
Dissections occur most often in men ages 40–70, but younger adults with genetic conditions can also be affected.
Symptoms of Aortic Dissection
Symptoms usually appear suddenly and may mimic those of a heart attack or stroke. Common warning signs include:
- Severe, sharp, or tearing pain in the chest or upper back
- Pain that spreads to the neck, jaw, abdomen, or legs
- Shortness of breath or difficulty breathing
- Fainting or weakness
- Stroke-like symptoms, such as trouble speaking, vision changes, or paralysis
- Differences in blood pressure between arms
- Rapid or weak pulse
If you or a loved one experiences these symptoms, call 911 immediately. Early diagnosis and treatment save lives.
How Aortic Dissections Are Diagnosed
Because the condition is often confused with a heart attack, accurate diagnosis is critical. At UHealth, patients suspected of having an aortic dissection undergo rapid testing including:
- CT angiography (CTA): Fast, highly accurate imaging test that uses dye to highlight blood flow in the aorta.
- Transesophageal echocardiogram (TEE): An ultrasound probe placed in the esophagus to capture detailed images of the aorta.
- Magnetic resonance imaging (MRI): Used in stable patients for detailed evaluation of the aortic wall.
- Electrocardiogram (EKG) and blood tests: Help rule out a heart attack and guide treatment decisions.
The team use these tests to quickly confirm diagnosis and determine whether surgery, stent repair, or medication is the best option.
Treatment Options at UHealth
Treatment depends on the type and severity of the dissection.
Type A Dissection (Ascending Aorta)
- Requires emergency open-heart surgery.
- Surgeons replace the damaged portion of the aorta with a synthetic graft.
- If the aortic valve is affected, repair or replacement may also be necessary.
Type B Dissection (Descending Aorta)
- May be treated initially with medications to lower blood pressure and heart rate, reducing stress on the aortic wall.
- If complications develop (such as ongoing pain, organ damage, or risk of rupture), minimally invasive or surgical repair is needed.
Treatment options include:
- Endovascular stent grafting (TEVAR): A catheter-based procedure where a stent graft is placed inside the aorta to reinforce the wall and redirect blood flow. This can reduce recovery time compared to open surgery.
- Open surgery: Required for more complex cases where stent grafting is not possible.
Recovery and Long-Term Care
Recovery depends on the severity of the dissection and the type of treatment. After surgery or TEVAR, most patients stay in the hospital for monitoring. Medications to control blood pressure are usually needed for life.
At UHealth, patients receive long-term follow-up that includes:
- Regular imaging (CT or MRI) to monitor the aorta.
- Blood pressure management to reduce stress on the vessel wall.
- Genetic counseling if an inherited condition is suspected.
- Lifestyle support for smoking cessation, diet, and exercise.
Our Location
Cardiac Surgery at UHealth Tower
1400 Northwest 12th Avenue, Suite 1
Miami, FL 33136
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Our Experts
Why Choose UHealth for Aortic Dissection Treatment?
Expert, Coordinated Care. Multidisciplinary teams in vascular surgery, cardiothoracic surgery, cardiology, and interventional radiology work together for each patient.
Advanced Treatment Options. From complex open-heart surgery to minimally invasive stent grafting, UHealth offers the full spectrum of care.
24/7 Emergency Response. Our facilities are equipped to evaluate and treat dissections at any hour.
Academic Medical Excellence. As part of the University of Miami Miller School of Medicine, UHealth leads research in aortic disease and offers patients access to the latest innovations.
Comprehensive Follow-Up Care. Lifelong monitoring, genetic testing, and preventive care help protect patients from future complications.
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