de

After an Aortic Dissection – Who Will Look After Me Now? 

                                                   

After an aortic dissection and emergency surgery, leaving hospital can feel like the beginning of a completely new and unfamiliar journey. You may have spent weeks in hospital and possibly in cardiac rehabilitation. Suddenly, you are back home – but you may still have many questions:

Who is responsible for my follow-up? When will my aorta be checked again? Which doctor should I contact? And what happens next? There is no single follow-up plan that is right for everyone. Your care will depend on the type of dissection, the surgery or treatment you received, whether any part of the dissection remains, and your individual health needs.

Here is an overview of the healthcare professionals who may be involved.



1. Your GP – your local point of contact

Your GP can be an important part of your recovery after leaving hospital.
They may help with:

  • repeat prescriptions and medication
  • blood pressure monitoring
  • checking your general recovery
  • monitoring your surgical wound or scar
  • sick notes and other medical paperwork
  • referrals to other specialists when needed
  • coordinating some aspects of your ongoing care

It is a good idea to make sure your GP has received your hospital discharge summary and understands what happened during your admission.

The Vascular Society recommends arranging an appointment with your GP after returning home so that medication and longer-term care can be discussed.

2. Your hospital consultant and specialist aortic team

After an aortic dissection, your hospital team remains an important part of your follow-up, particularly during the first months. The Vascular Society's patient guide states that most patients initially return to see the consultant who looked after them in hospital. Later, some patients may be followed by another specialist, such as a cardiologist.

Your first follow-up appointment may include questions about:

  • how you are recovering
  • any new or ongoing symptoms
  • your blood pressure
  • your medication
  • your surgical wound
  • your physical recovery
  • when further imaging is needed
  • your longer-term follow-up plan

For some patients, this appointment takes place around 6–8 weeks after discharge. In other situations, particularly after an uncomplicated medically managed Type B dissection, the first appointment may be around
3 months. The exact timing depends on your individual situation.

This appointment is important

You may still be recovering physically and emotionally at this stage. You do not need to have everything figured out. It can help to write down your questions before the appointment and bring a list of your medications and recent blood pressure readings.

3. CT or MRI – monitoring your aorta

Regular imaging is an important part of long-term follow-up after an aortic dissection. CT angiography or MRI can be used to monitor the aorta and check for changes over time.

After Type A dissection surgery, there may still be a dissected section of the aorta beyond the area that was repaired. This remaining part of the aorta needs ongoing surveillance. The same applies to patients with Type B dissection, where changes in the aorta may occur over time.

The timing of scans is individual. There is no single schedule that applies to every patient. Your specialist team will decide how often imaging is needed based on your operation, the remaining aorta and your previous scan results. Current European guidance supports structured long-term imaging follow-up after acute aortic syndromes.

4. Cardiology

A cardiologist may be involved in your longer-term care, depending on your individual situation.
They monitor:

  • blood pressure
  • heart function
  • heart valves
  • heart rhythm
  • symptoms such as breathlessness, palpitations or chest discomfort
  • medication and cardiovascular risk factors

Not every patient needs regular appointments with a cardiologist. In the UK, responsibility for longer-term follow-up may vary between specialist aortic teams, cardiologists and other services.

The important thing is that you know who is responsible for monitoring your aorta and who you should contact if you have concerns.

5. Vascular or aortic specialists

Depending on the extent of your dissection, other parts of the aorta or other blood vessels may also need monitoring. Your specialist team may involve vascular surgery, vascular medicine, interventional radiology or other specialists when necessary.

This may be particularly relevant if there are changes in:

  • the descending aorta
  • abdominal or pelvic arteries
  • blood flow to the legs or other organs
  • areas of the aorta that were not treated during your original operation

In the UK, specialist aortic care is increasingly organised through multidisciplinary teams (MDTs) involving cardiac surgery, vascular surgery, radiology, cardiology and, where appropriate, genetics. NHS England describes regional aortic centres with specialist multidisciplinary teams for acute aortic dissection.

6. Neurology – if your brain or nerves were affected

An aortic dissection can sometimes affect blood flow to the brain, spinal cord or other organs. Neurological follow-up may be important if you have experienced:

  • a stroke or TIA
  • weakness or paralysis
  • numbness or altered sensation
  • problems with speech or understanding
  • visual problems
  • ongoing neurological symptoms

Not everyone needs neurological follow-up. It depends on what happened during your dissection and how you are recovering.

7. Your dentist

Regular dental care is still important after a major cardiovascular operation.

Antibiotic prophylaxis for infective endocarditis is recommended only for specific patients who are considered to be at increased risk. If you have a prosthetic heart valve or another condition that places you in a higher-risk group, ask your cardiology or medical team and tell your dentist before treatment.

What about cardiac rehabilitation?

Cardiac rehabilitation can be an important part of recovery after major heart and aortic surgery. It may help you gradually rebuild physical confidence and learn more about:

  • safe exercise
  • physical activity
  • healthy lifestyle choices
  • blood pressure
  • medication
  • returning to everyday activities

Recovery is not only about the physical side. After an emergency aortic dissection, it is completely understandable to feel anxious, overwhelmed or uncertain about what your body can safely do. You may need time to rebuild confidence.

Your follow-up plan should be clear

The Vascular Society's patient guidance specifically recommends asking the hospital team who will be responsible for your follow-up before you leave hospital.

It can also be helpful to keep your own aortic folder, either on paper or digitally, containing:

  • your discharge summary
  • operation report
  • CT and MRI reports
  • medication list
  • blood pressure readings
  • letters from specialists
  • appointment dates
  • details of your aortic centre or specialist team
  • information about any graft, stent or prosthetic valve you may have

Having this information together can make future appointments much easier.

You don't have to work it all out on your own

After an emergency aortic operation, there can be a lot to take in. In the first weeks, your priority is often simply recovering, getting stronger and finding your way back into everyday life. You do not have to understand everything about your aorta immediately.

As you recover, you may gradually feel ready to ask more questions and understand what happened to you and what your long-term follow-up will involve.

Good follow-up is a long-term process – not something you have to figure out all at once.


Important

This information is intended as general guidance for patients and families after aortic dissection. It does not replace individual medical advice.

Follow-up arrangements vary between patients and hospitals. Your own specialist team should determine the appropriate schedule for appointments and imaging based on your operation, your aorta and your individual medical needs.

If you develop sudden or severe symptoms, do not wait for your next routine appointment. Seek urgent medical attention.


Sources: Vascular Society of Great Britain and Ireland – Aortic Dissection: The Patient Guide  •  NHS England – South England Aortic Dissection Network •  Barts Health NHS Trust – Advice when having aortic surgery
2024 ESC Guidelines


This text was created by AD-Selbsthilfe. Reproduction, publication or use of this content, in whole or in part, requires prior permission from AD-Selbsthilfe.