Management of Acute Type A Aortic Dissection

Abstract

This article reviews the management of acute type A aortic dissection (ATAAD), from initial temporizing medical therapy to the technical aspects of urgent surgical repair, which is the definitive treatment for ATAAD. Surgical repair and the extent of aortic resection and replacement are dictated by the location and extent of intimal tears, as well as aneurysmal dilation of the aorta. Cardiopulmonary bypass, hypothermic circulatory arrest, and cerebral perfusion are major considerations in management of this acute process. Several techniques pertinent to each portion of the involved aorta and relevant intraoperative management points are also discussed.

Keywords: Emergent; Intimal tear; Perfusion; Surgical repair; Type A aortic dissection.