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Aortic Dissection Treatment

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Managing even the most challenging aortic tears

Expert Heart & Vascular Care

Getting the care you need starts with seeing one of our heart or vascular specialists.

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Aortic dissection is a serious and sometimes fatal condition, but the experts in our Complex Aortic Center are helping more people live long and healthy lives. Our vascular and cardiac surgeons work together to repair even the most complex tears in the body’s largest blood vessel, including using a minimally invasive approach called endovascular repair.

image of surgeons performing an aortic dissection

Some of our patients travel hundreds of miles to receive the specialized surgeries they need for aortic dissections. They may have been told by other doctors that they were too ill for surgery, or they may have multiple tears that created new blood passageways that require advanced skills and technology to repair. We’ll work with you to find the best option to treat your aortic dissection with medication, endovascular repair or traditional open surgery.

Vascular and Endovascular Program

Partner with a recognized leader in offering care ranging from straightforward vascular disease to the most complex vascular disorders.

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Types of Aortic Dissection Treatment

Medication

Medication can play an important role in treating aortic dissections by lowering blood pressure and relieving strain on the damaged aorta. Even if your dissection needs to be repaired, your doctor will likely still prescribe medication.

We start most patients on a beta blocker to lower blood pressure by widening the arteries, blocking adrenaline and reducing the force of your heart’s contractions. You also may be prescribed:

  • ACE inhibitors
  • Calcium channel blockers
  • Nitroprusside (to relax blood vessels)

Aortic dissection surgery

Surgery is the standard treatment for Type A dissections (ascending aorta), though some patients are too sick to undergo an operation and may rely on medication. Patients with Type B dissections (descending aorta) also may need to be treated if:

  • A large aneurysm has formed
  • Medication cannot manage the condition
  • The aorta is at risk of rupturing
  • The dissection is interfering with the major arteries branching off the aorta, causing problems in organs or the arms or legs
  • There is internal bleeding

For Type A dissections you will be given general anesthesia and placed on cardiopulmonary bypass, in which a machine temporarily takes over the function of the heart and lungs. This allows the surgical team to slow the heart and clear the aorta of blood, while still providing blood and oxygen to the body. Your body temperature will be lowered so that you consume less oxygen.

The surgeon will make an incision in the aorta to inspect the extent of the tear and determine if other vessels or body parts also require repair. The damaged aorta will be replaced with a long-lasting synthetic graft. Type A dissections also may damage the aortic root. This damage usually can be repaired, but in some cases, the aortic root may need to be replaced. This involves removing the aortic tissue and replacing it with a long-lasting synthetic graft, reattaching the coronary arteries and repairing or replacing the aortic valve.

Finally, your body will be warmed, you’ll be taken off bypass and the incision will be closed. The procedure takes five to 10 hours, and you’ll need to stay in the hospital seven to 10 days. It can take several months to fully recover.

Endovascular repair

While surgery remains an important tool for treating Type A dissections (ascending aorta), our team is among those advancing minimally invasive repair for patients with Type B dissections (descending aorta). Endovascular repair offers advantages over open surgery, including less pain, faster recovery and fewer complications.

Before the procedure, you’ll be given either general anesthesia or a local anesthetic and sedative. The doctor will make two small punctures to access the femoral artery in your groin, through which they will thread two thin, flexible tubes known as catheters through the artery to the dissection and treat the dissection with a stent graft.

The procedure will take two to three hours, and you’ll likely spend a day or two in the hospital.

Conditions

Aneurysms

An aneurysm is a ballooning or expansion of a blood vessel. Aneurysms most often develop in arteries, though they also can develop in veins or even inside the heart.

Aortic Dissection

A dissection is a tear in the lining of the aorta, the candy cane-shaped artery that delivers oxygen-rich blood from the heart to the rest of the body.

Tests

Cardiac Catheterization

Cardiac catheterization is a minimally invasive way to diagnose and treat a variety of heart and vascular conditions by guiding thin, flexible tubes called catheters through blood vessels to problem areas.

Computerized Tomography (CT) Scan

The cardiac computed tomography scan, or cardiac CT, uses X-rays to create three-dimensional images of your heart and blood vessels.

Magnetic Resonance Imaging (MRI)

Magnetic resonance imaging, better known as cardiac MRI, is a combination of radio waves, magnets and computer technology to create images of your heart and blood vessels.

Transesophageal Echocardiogram (TEE)

Transesophageal echocardiogram allows us to take very detailed images of your heart structure from a probe in your esophagus.

Physicians

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35 Doctors & Specialists
Dr. Alena Lira, MD
Dr. Alena Lira, MD
Cardiac Critical Care
110 Irving Street Northwest Suite 4B42 Washington, DC 20010
(202) 877-7259
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Dr. Javairiah Fatima, MD
Dr. Javairiah Fatima, MD
Vascular Surgery
18101 Prince Philip Drive Olney, MD 20832
(301) 774-8962
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Dr. Stephen Fulvio Stanziale, MD
Dr. Stephen Fulvio Stanziale, MD
Vascular Surgery
(282)
9101 Franklin Square Drive Outpatient Center, Suite 212 Baltimore, MD 21237
(443)-777-1900
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Dr. Benjamin B. Kenigsberg, MD
Dr. Benjamin B. Kenigsberg, MD
Cardiac Critical Care
110 Irving Street Northwest Room 4B-1 Washington, DC 20010
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Dr. Jennifer Yu, MD
Dr. Jennifer Yu, MD
Cardiac Critical Care
110 Irving Street Northwest Suite 4B42 Washington, DC 20010
(202) 877-7259
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Dr. Kevin Arthur Brown, MD
Dr. Kevin Arthur Brown, MD
Vascular Surgery
2002 Medical Parkway Suite 520 Annapolis, MD 21401
410-571-8430
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Dr. Akram M. Zaaqoq, MD
Dr. Akram M. Zaaqoq, MD
Cardiac Critical Care
110 Irving Street Northwest Suite 4B42 Washington, DC 20010
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Dr. Lucy B. Kupersmith, MD
Dr. Lucy B. Kupersmith, MD
Vascular Surgery
1630 Main Street Suite 208 Chester, MD 21619
(410) 571-8430
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Dr. John Harvey, MD
Dr. John Harvey, MD
Vascular Surgery
(267)
24035 Three Notch Road Hollywood, MD 20636
(301) 373-7900
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Dr. Alexandra Kristina Pratt, MD
Dr. Alexandra Kristina Pratt, MD
Critical Care Medicine
110 Irving Street Northwest Room 4B-42 Washington, DC 20010
(202) 877-7259
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Dr. Arthur C. St. Andre, MD
Dr. Arthur C. St. Andre, MD
Cardiac Critical Care
110 Irving Street Northwest Suite 4B42 Washington, DC 20010
(202) 877-7259
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Dr. Joshua A. Dearing, MD
Dr. Joshua A. Dearing, MD
Vascular Surgery
(193)
7501 Surratts Road 208 Clinton, MD 20735
301-877-7353
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Dr. Chadi Tanios Abouassaly, MD
Dr. Chadi Tanios Abouassaly, MD
Cardiac Critical Care
110 Irving Street Northwest Room 4B39 Washington, DC 20010
(202) 877-7259
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Dr. Arthur Flatau, III, MD
Dr. Arthur Flatau, III, MD
Vascular Surgery
(316)
25500 Point Lookout Road Floor 2 Leonardtown, MD 20650
(240) 434-4072
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Dr. Alexander I. Papolos, MD
Dr. Alexander I. Papolos, MD
Cardiac Critical Care
(202) 877-7259
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Dr. Michael J. Hockstein, MD
Dr. Michael J. Hockstein, MD
Cardiac Critical Care
110 Irving Street Northwest Suite 4B42 Washington, DC 20010
(202) 877-7259
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Dr. Raghuveer Vallabhaneni, MD
Dr. Raghuveer Vallabhaneni, MD
Vascular Surgery
(179)
3333 North Calvert Street Johnston Professional Building Baltimore, MD 21218
(410) 554-2950
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Dr. Pamela M. Paufler, MD
Dr. Pamela M. Paufler, MD
Cardiac Critical Care
110 Irving Street Northwest Suite 4B42 Washington, DC 20010
(202) 877-7259
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Dr. Edward Yiming Woo, MD
Dr. Edward Yiming Woo, MD
Vascular Surgery
(239)
106 Irving Street Northwest Physician Office Building North Tower, Suite 3150 Washington, DC 20010
(202) 877-0275
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Dr. Brian George Lee, MD
Dr. Brian George Lee, MD
Cardiac Critical Care
110 Irving Street Northwest Suite 4B42 Washington, DC 20010
(202) 877-7259
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Dr. Suzanne Siefert Kool, MD
Dr. Suzanne Siefert Kool, MD
Vascular Surgery
(182)
5601 Loch Raven Boulevard GSH SMYTH BLDG Baltimore, MD 21239
(410) 554-2950
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Dr. Jason Andrew Chin, MD
Dr. Jason Andrew Chin, MD
Vascular Surgery
5601 Loch Raven Boulevard Smyth Bldg Ste 303 Baltimore, MD 21239
(443) 444-3431
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Dr. Jason Ryan Crowner, MD
Dr. Jason Ryan Crowner, MD
Vascular Surgery
5601 Loch Raven Boulevard GSH SMYTH BLDG Baltimore, MD 21239
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Dr. Ayesha Nzeribe Hatch, MD
Dr. Ayesha Nzeribe Hatch, MD
Vascular Surgery
106 Irving Street Northwest Suite NW Washington, DC 20010
(202) 877-3100
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Dr. Misaki Mikki Kiguchi, MD
Dr. Misaki Mikki Kiguchi, MD
Vascular Surgery
(364)
3800 Reservoir Road Northwest 4th Floor Washington, DC 20007
(202) 444-2255
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Dr. Steven David Abramowitz, MD
Dr. Steven David Abramowitz, MD
Vascular Surgery
(237)
106 Irving Street Northwest Suite 3150 Washington, DC 20010
(202) 877-0275
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Dr. Seife Yohannes, MD
Dr. Seife Yohannes, MD
Cardiac Critical Care
110 Irving Street Northwest Suite 4B42 Washington, DC 20010
(202) 877-7259
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Dr. Geetha Jeyabalan, MD
Dr. Geetha Jeyabalan, MD
Vascular Surgery
(268)
2002 Medical Parkway Suite 520 Annapolis, MD 21401
(410) 571-8430
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Dr. Cameron M. Akbari, MD, MBA
Dr. Cameron M. Akbari, MD, MBA
Vascular Surgery
(278)
106 Irving Street Northwest Suite 3600 Washington, DC 20010
(202) 444-2255
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Dr. Nimesh Satish Shah, MD
Dr. Nimesh Satish Shah, MD
Cardiac Critical Care
110 Irving Street Northwest Room 4B Washington, DC 20010
(202) 877-7259
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Dr. Krystal C. Maloni, MD
Dr. Krystal C. Maloni, MD
Vascular Surgery
110 Irving Street Northwest Center for Vascular Care Washington, DC 20010
202-416-2000
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Dr. Kevin Grant Handy, MD
Dr. Kevin Grant Handy, MD
Cardiac Critical Care
110 Irving Street Northwest Suite 4B42 Washington, DC 20010
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Dr. Stephen M. Luczycki, MD
Dr. Stephen M. Luczycki, MD
Cardiac Critical Care
110 Irving Street Northwest Suite 4B42 Washington, DC 20010
(202) 877-7259
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Dr. Mark O'Brien Peeler, MD
Dr. Mark O'Brien Peeler, MD
Vascular Surgery
(469)
2002 Medical Parkway Suite 520 Annapolis, MD 21401
(410) 571-8430
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Dr. Margaret Walkup Arnold, MD
Dr. Margaret Walkup Arnold, MD
Vascular Surgery
9000 Franklin Square Drive Baltimore, MD 21237
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MedStar Union Memorial Hospital
201 East University Parkway Baltimore, MD 21218
(410) 554-2266
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MedStar Washington Hospital Center
110 Irving Street Northwest Washington, DC 20010
202-877-7464
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