Aortic Dissection Treatment in United Arab Emirates

What is an Aortic Dissection?

An aortic dissection occurs when a tear in the aorta's inner lining lets blood into the wall and separates its layers, creating a false lumen. The dissection may involve the ascending aorta, descending thoracic aorta, abdominal aorta, or multiple segments.

Aortic dissections are commonly classified as:

• Type A: Involves the ascending aorta and may extend into the aortic root, arch, coronary arteries, or other branches.
• Type B: Does not involve the ascending aorta and usually begins in the descending aorta.

A dissection can interfere with blood flow to the heart, brain, kidneys, intestines, spinal cord, or limbs and may cause complications such as rupture, cardiac tamponade, aortic valve leakage, stroke, or organ ischemia.

What is the Importance of Timely Treatment?

Aortic dissection can rapidly become life-threatening. A tear involving the ascending aorta can lead to rupture, cardiac tamponade, aortic regurgitation, coronary artery obstruction, stroke, or reduced blood flow to other organs. It requires immediate evaluation by an experienced aortic or cardiac surgical team, with emergency operative repair generally recommended. Stable patients may be transferred to a high-volume aortic centre with appropriate expertise.

What are the Common Symptoms of an Aortic Dissection?

• Sudden, severe chest pain
• Severe upper-back pain
• Pain that may spread to the neck, jaw, abdomen, or back
• Shortness of breath
• Fainting or loss of consciousness
• Sweating, weakness, or a feeling of impending illness
• Stroke-like symptoms such as weakness, numbness, confusion, or difficulty speaking
• Abdominal pain
• Reduced blood flow to an arm or leg, which may cause pain, weakness, numbness, or a cold limb
• Unequal blood pressure or pulses between limbs

Causes and Risk Factors of Aortic Dissection

Causes

• Long-standing or severe hypertension
• Aortic aneurysm
• Genetic connective-tissue disorders
• Marfan syndrome
• Loeys-Dietz syndrome
• Vascular Ehlers-Danlos syndrome
• Bicuspid aortic valve and associated aortic disease
• Previous aortic surgery or procedures
• Significant chest trauma
• Certain inflammatory or vascular conditions
• Pregnancy-related aortic disease in susceptible individuals

Risk Factors

• Uncontrolled high blood pressure
• Personal or family history of aortic disease
• Thoracic aortic aneurysm
• Inherited aortic disorders
• Bicuspid aortic valve
• Increasing age
• Smoking
• Previous aortic surgery

Latest Research and Technologies in the Treatment of Aortic Dissection in the United Arab Emirates

• Current management of aortic dissection focuses on rapid diagnosis, accurate aortic assessment, and timely selection of medical, surgical, or endovascular treatment. CT angiography is commonly used to determine the dissection's location and extent and to assess blood flow to major branches. Acute Type A aortic dissection generally requires emergency open surgical repair. Uncomplicated Type B dissection is often managed initially with intensive blood pressure and heart-rate control, while complicated or selected high-risk cases may require thoracic endovascular aortic repair (TEVAR) or open surgery.