How is aortic dissection treated?

Aortic dissection has a high mortality rate and must be managed promptly and accurately. The following are the main treatment measures:

1. Immediate management: Close monitoring of the patient's hemodynamic parameters, including blood pressure and heart rate. The patient must remain strictly at bed rest, with potent sedation and analgesia administered if necessary.

2. Pharmacological therapy: Primarily used to control blood pressure and heart rate, reduce aortic wall stress, and prevent further extension of the dissection. Commonly used medications include beta-blockers, calcium channel blockers, and vasodilators such as sodium nitroprusside.

3. Interventional therapy: Has become the preferred treatment option for most cases of descending aortic dissection. This procedure involves placing a stent graft within the aorta to seal the intimal tear and expand the true lumen. It is minimally invasive, allows for rapid recovery, and is associated with low mortality and complication rates.

4. Surgical treatment: For patients with involvement of the ascending aorta or severe complications such as acute pericardial tamponade, aortic valve insufficiency, or visceral or limb ischemia, immediate open surgery is required. This involves replacing the affected segment of the aorta, and in some cases, replacement of the aortic valve may also be necessary.