Complications

In-hospital mortality due to aortic dissection ranges from 9 to 39%, depending on the type of dissection and treatment modality.

• A complication of aortic dissection where blood flow to major vascular beds is interrupted, resulting in ischemia and end-organ damage

• Myocardial infarction (coronary artery occlusion)

• Aortic regurgitation (extension of the dissection into the aortic valve)

• Cardiac tamponade progressing to cardiogenic shock

• Pericarditis, pericardial effusion, and pericardial tamponade (slow extension of the dissection into the pericardium)

• Stroke (extension of the dissection into the carotids)

• Bleeding into the thorax, mediastinum, and abdomen

• Arterial occlusion followed by ischemia of the:

  • Celiac trunk, superior/inferior mesenteric artery → acute abdomen, ischemic colitis

  • Renal arteries → acute renal failure (oliguria, anuria)

  • Spinal arteries → weakness of lower extremities or acute paraplegia

  • Complete occlusion of the distal aorta → Leriche syndrome (aortoiliac occlusive disease)

• Aortic rupture and acute blood loss: acute back and flank pain (tearing pain), symptoms of shock → indication for emergency surgery

• Blood pressure control

• Smoking cessation

• Screening and repair of rapidly expanding aneurysms