Type A Aortic Dissection

Dr Lim Chong Hee

Dangerous and rare conditions of the heart

Aortic dissection

Aortic dissection is a serious condition where the wall of the aorta tears and there is a false lumen forming in the wall of the aorta.

This condition may present acutely and may be life threatening.

Symptoms of acute aortic dissection include severe chest pains radiating to the back, as if someone had driven a knife through your back, shortness of breath and loss of consciousness.

According to the Stanford classification, acute aortic dissection can be divided into two types, A and B.

Type A is when the dissection involves the ascending aorta and type B is where it involves parts other than the ascending aorta.

The classification has implications to management and outcomes.

Type A acute aortic dissection is life threatening and presents as a surgical emergency.

Death can occur within minutes or hours if the dissection causes the aorta to rupture, bleeding into the pericardium resulting in cardiac tamponade, or from a massive heart attack if the dissection involves the coronary arteries.

Surgical intervention is urgent and life saving.

The aim is to interrupt the dissection in the ascending aorta and to prevent the false lumen from expanding in the future.

The AMDS aortic stent is the latest technology for heart surgeons when it comes to repair of ascending aortic dissections. It is a self-expanding stent deployed at the same setting of the aortic surgery repair. This device is placed into the true lumen of the aorta down to the descending aorta. It is self expanding and will over a short period of time gradually compress the false lumen and obliterate it.

This device is available in Singapore.

Short video of CT scan of aortic dissection and after repair.

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