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Editorial
. 2024 Oct 31;25(11):389.
doi: 10.31083/j.rcm2511389. eCollection 2024 Nov.

Challenges and Innovations in Postoperative Care for Acute Type A Aortic Dissection: The Role of Structured Surveillance and Virtual Wards

Robert Pruna-Guillen  1 , Laerke Ghosh  1 , Tara M Mastracci  1 , Vikas Kapil  2   3   4 , Ana Lopez-Marco  1 , Aung Oo  1 ; on behalf the of the rest of the aortic dissection surgical team at Barts Heart Centre (London, UK)
Affiliations
Editorial

Challenges and Innovations in Postoperative Care for Acute Type A Aortic Dissection: The Role of Structured Surveillance and Virtual Wards

Robert Pruna-Guillen et al. Rev Cardiovasc Med. .

Abstract

Acute Type A aortic dissection (ATAAD) represents a life-threatening medical emergency that requires emergent surgical repair. Despite improvement in surgical techniques and perioperative management, ATAAD remains associated with high early mortality and postoperative complications. A structured and individualized postoperative surveillance program is essential, not only for improving survival rates but also for identifying risk factors necessitating reintervention and enhancing the quality of life. Comprehensive postoperative care should address both medical monitoring and psychological support to meet the holistic needs of ATAAD survivors. In real-world settings adherence to guideline-directed imaging surveillance (GDIS) is poor, leading to underestimation of reintervention rates. A comprehensive aortic service should include GDIS, clinical assessments, cardiovascular risk management, and psychological support. Since August 2022, a virtual ward has been implemented in our department to facilitate remote monitoring, ensuring tight blood pressure control and early detection of complications.

Keywords: Type A aortic dissection; aortic dissection; blood pressure control; guideline-directed imaging surveillance; postoperative management; virtual wards.

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Conflict of interest statement

The authors declare no conflict of interest.

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