In the case of an internal tear in the aorta, the blood burrows its way between the inner two wall layers and the outer wall layer of the aorta and thus forms an additional (false) clearing within the aorta. The patient usually feels a sharp pain between the shoulder blades or in the area of the sternum, which travels downwards along the spine. The main danger of aortic dissection is that it can lead to insufficient blood flow to organs (brain, heart, liver, kidneys) or limbs because important branches of the aorta are displaced or constricted by the floating inner membrane. Occasionally, the pressure on the outer layer can be so great that it tears, causing severe bleeding. The patient then finds himself or herself in a life-threatening situation within a very short space of time.
Replacement of the ascending aorta with a valve and vascular prosthesis with re-implantation of the coronary vessels.
Acute dissection of the ascending aorta is practically always treated in an emergency and the diseased aortic segment is replaced with a vascular prosthesis. Dissections that primarily affect the descending aorta or, much more rarely, the abdominal aorta are initially treated conservatively, i.e. by lowering the blood pressure with medication and painkillers. Insufficient blood flow to the abdominal organs or legs can often be improved by inserting a stented vascular prosthesis via an inguinal access.
Regardless of the type of treatment, patients must be monitored for the rest of their lives after an aortic dissection, as the wall layers of the aorta remain weakened after the tear. The diameter of the aorta can continue to grow slowly as a result.