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It’s Topic Tuesday! - Aortic Dissection



Welcome back, everyone! Today, we’ll be discussing aortic dissections. An aortic dissection is a serious and scary diagnosis to hear. The name alone can sound overwhelming, and the details are often explained quickly during a stressful moment. One of the first things doctors talk about is whether the dissection is Type A or Type B. While that may sound like medical shorthand, the difference is actually pretty simple — and very important.


What is an aortic dissection?


The aorta is the large artery that carries blood from your heart to the rest of your body. Its wall has several layers. An aortic dissection happens when a tear forms in the inner layer, allowing blood to flow between the layers and split them apart. This can weaken the aorta and interfere with blood flow to vital organs. 


Type A dissection: involves the ascending aorta


A Type A dissection affects the part of the aorta closest to the heart (the ascending aorta), and may also extend into the arch or beyond.

  • Why it’s dangerous: This area is under high pressure and close to the heart and aortic valve, making it more prone to rupture or have serious complications

  • Typical treatment: Type A dissections almost always require emergency surgery.

  • Goal of surgery: Remove the torn section of the aorta, prevent rupture, and restore normal blood flow.


Because of the risks involved, Type A dissections are treated as life-threatening emergencies.


Type B dissection: starts farther down


A Type B dissection begins in the descending aorta, farther away from the heart.

  • Why it’s different: The pressure is lower than in the ascending aorta, and complications often develop more slowly.

  • Typical treatment: Many Type B dissections can be treated without surgery, using medications to control blood pressure and heart rate.

  • When surgery is needed: If there are complications such as poor blood flow to organs, ongoing pain, or a rapidly enlarging aorta.


There are a couple of different ways doctors can classify aortic dissections. The two commonly used ways are the Stanford System and the DeBakey System. Source: https://www.saem.org/about-saem/academies-interest-groups-affiliates2/cdem/for-students/online-education/m4-curriculum/group-m4-cardiovascular/thoracic-aortic-dissection
There are a couple of different ways doctors can classify aortic dissections. The two commonly used ways are the Stanford System and the DeBakey System. Source: https://www.saem.org/about-saem/academies-interest-groups-affiliates2/cdem/for-students/online-education/m4-curriculum/group-m4-cardiovascular/thoracic-aortic-dissection

Why classification matters

The Type A vs. Type B label helps doctors decide how urgently treatment is needed and what kind of treatment is safest. It’s not a measure of how “bad” the dissection is — it’s a guide to choosing the right approach at the right time.


Life after a dissection


Many people live full and active lives after an aortic dissection. Long-term care usually includes blood pressure control, regular imaging, and ongoing follow-up with heart and vascular specialists. Early diagnosis and proper management make a huge difference in outcomes.


Bottom line


Type A and Type B aortic dissections are both serious, but they’re treated very differently. Type A usually requires urgent surgery, while Type B is often managed with careful medical therapy. Understanding the difference can help patients and families feel more informed and empowered during a very stressful time.


As always, here are some great resources if you want to take a deeper dive into this topic:


Society for Vascular Surgery: Aortic Dissection Overviewhttps://vascular.org/patients/vascular-conditions/aortic-dissection


Mayo Clinic: Aortic Dissection


Til next time,

Anirudh Karla


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