An aortic dissection is a tear in the wall of the aorta. This tear is often associated with back pain and can be an emergency if present in the ascending aorta or if the tear involves the blood vessels that go to the abdominal organs including the kidneys, liver, and intestines. These so-called complicated dissections require an emergent operation either endovascular or open to repair the injury. If this is not the case, the primary treatment will be blood pressure control and if the pain goes away, then planning for a procedure can be done electively.
For “uncomplicated” aortic dissections, current literature has found that patients should undergo an elective repair at 14 days to 90 days after the tear occurs. The vast majority of patients can undergo thoracic endovascular repair of their tear with a covered stent graft. The goal is to cover the tear in the aorta and restore normal flow. This repair is done because over time the torn aorta has a tendency to form a large aneurysm that is at high risk of rupture. Doing the TEVAR in this early time period improves longterm survival. VSA physicians are part of the Cedars Sinai Aortic Center and repair these routinely.