The current standard of care only replaces the ascending aorta. After “successful” treatment, over 75% of the patients are left with a residual tear in the remainder of the aorta as shown in the image. Even though this is known during the first operation, the patients are extremely ill, and cannot withstand an additional 3 hours of surgery to remove additional parts of the aorta. Therefore, the patient is closed up, and is given time to heal, knowing that there is still a major problem that will need to be dealt with later. In addition, the side effects from removing the remaining tear during the first operation can be severe, due to the need to relocate the blood vessels that supply the brain. These include death, strokes, brain damage, and paralysis. Therefore, surgeons only replace the ascending aorta during the initial emergency surgery.
